Organization
AFFINITY CLINICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL NDUPU LCMHCS, CCS, LCAS (CLINICAL DIRECTOR, OWNER)
(980) 224-8060
Entity
Organization
Contact information
Practice address
5500 EXECUTIVE CENTER DRIVE, SUITE 118, CHARLOTTE, NC 28212
(980) 224-8060
(704) 379-1914
Mailing address
5500 EXECUTIVE CENTER DRIVE, SUITE 118, CHARLOTTE, NC 28212
(980) 224-8060
(704) 379-1914
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
4936
NC
251X00000X
Supports Brokerage Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103653
—
NC
Enumeration date
04/17/2017
Last updated
06/19/2023
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