Organization
PROFOUND COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL MOORE LCMHC (OWNER)
(704) 575-7816
Entity
Organization
Contact information
Practice address
3540 TORINGDON WAY STE 200, CHARLOTTE, NC 28277-4650
(704) 575-7816
Mailing address
3540 TORINGDON WAY STE 200, CHARLOTTE, NC 28277-4650
(704) 575-7816
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
07/22/2022
Last updated
05/02/2024
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