Organization
CHARLOTTE COUNSELING AND CONSULTING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMARR FUNDERBURG LICSW (OWNER)
(704) 771-4633
Entity
Organization
Contact information
Practice address
1905 J N PEASE PL STE 202, CHARLOTTE, NC 28262-4539
(704) 771-4633
(980) 225-5555
Mailing address
1905 J N PEASE PL, CHARLOTTE, NC 28262-4557
(704) 771-4633
(980) 225-5555
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
10648
SC
251S00000X
Community/Behavioral Health Agency
Primary
10648
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1167535
—
SC
Enumeration date
05/08/2017
Last updated
12/13/2021
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