Organization
COUNSELING 1-2-1,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY GWEN HALES LCAS (CLINICAL THERAPIST)
(704) 587-5469
Entity
Organization
Contact information
Practice address
11030 S TRYON ST STE 302, CHARLOTTE, NC 28273-6626
(704) 587-5469
(704) 587-5463
Mailing address
11030 S TRYON ST STE 302, CHARLOTTE, NC 28273-6626
(704) 587-5469
(704) 587-5463
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1701
NC
Other
Enumeration date
09/19/2011
Last updated
09/19/2011
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