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Organization

VISIONARY PASSAGE COUNSELING AND CONSULTATION SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MONIQUE HEATH LPC, LCAS, CCS-I (CLINICAL DIRECTOR)
(704) 612-0180
Entity
Organization

Contact information

Practice address
615 E 6TH ST STE 2A, CHARLOTTE, NC 28202-2918
(704) 612-0180
Mailing address
3520 SIMMONS ST, CHARLOTTE, NC 28208-4754
(704) 726-4862

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
07/08/2019
Last updated
07/08/2019
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