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Organization

LESLIE H PETRUK MA LPC NCC

Active
Parent organization
THE STONE CENTER FOR COUNSELING & LEADERSHIP
Other names
The Stone Center for Counseling & Leadership
Organization subpart
Yes

Provider details

NPI number
Legal business name
THE STONE CENTER FOR COUNSELING & LEADERSHIP
Authorized official
LESLIE H PETRUK LPC, BCC (DIRECTOR)
(704) 604-8023
Entity
Organization

Contact information

Practice address
1106 HARDING PL, CHARLOTTE, NC 28204-2825
(704) 665-0065
(704) 335-4001
Mailing address
1106 HARDING PL, CHARLOTTE, NC 28204-2825
(704) 604-8023
(704) 335-4001

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4290
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1386G
BC/BS PROVIDER NUMBER
NC
05
6102653
NC
Enumeration date
08/18/2006
Last updated
03/13/2013
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