Organization
COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY O OWEN MA, LPCA (LICENSED PROFESSIONAL COUNSELOR ASS)
(704) 604-9249
Entity
Organization
Contact information
Practice address
17830 STATESVILLE RD, CORNELIUS, NC 28031-9173
(704) 604-9249
Mailing address
19116 CYPRESS GARDEN DR, DAVIDSON, NC 28036-8617
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A9672
NC
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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