Organization
LIVING WATER COUNSELING ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLYN SHELTON ROGERS (ADMINSTRATIVE ASSISTANT)
(704) 933-4673
Entity
Organization
Contact information
Practice address
301 S MAIN ST, KANNAPOLIS, NC 28081-3203
(704) 933-4673
(704) 933-4325
Mailing address
301 S MAIN ST, KANNAPOLIS, NC 28081-3203
(704) 933-4673
(704) 933-4325
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4478
NC
103TB0200X
Cognitive & Behavioral Psychologist
Primary
0324
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017GC
BLUE CROSS BLUE SHIELD
NC
01
—
7476812
AETNA
NC
Enumeration date
03/29/2007
Last updated
09/11/2025
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