Organization
INSIDE OUT COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE ELLEN LPC, LCAS (OWNER/PROVIDER)
(910) 754-7377
Entity
Organization
Contact information
Practice address
632 VILLAGE RD SW STE 2, SHALLOTTE, NC 28470-3434
(910) 754-7377
(910) 754-7378
Mailing address
PO BOX 2352, SHALLOTTE, NC 28459-2352
(910) 754-7377
(910) 754-7378
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10093
NC
251S00000X
Community/Behavioral Health Agency
LCAS 3399
NC
251S00000X
Community/Behavioral Health Agency
LPC 10093
NC
Other
Enumeration date
10/07/2015
Last updated
06/01/2016
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