Individual
MS. KISHA DENETTE SUMMERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS-A, LPC-A
Contact information
Practice address
100 BILLINGSLEY RD, CHARLOTTE, NC 28211-1002
(704) 376-7447
(704) 376-3384
Mailing address
100 BILLINGSLEY RD, CHARLOTTE, NC 28211-1002
(704) 376-7447
(704) 376-3384
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
A10899
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20291
NC
Other
Enumeration date
06/03/2015
Last updated
06/03/2015
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