| Alder Grove Counseling Collaborative, Pllc | |
|
5939 Frye Bridge Rd Clemmons NC 27012-9600 | |
| (336) 391-2803 | |
| Not Available |
| Full Name | Alder Grove Counseling Collaborative, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 5939 Frye Bridge Rd, Clemmons, North Carolina |
| Authorized Official Name and Position | Cheryl Denine Goldberg (CO-OWNER) |
| Authorized Official Contact | 3363912803 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alder Grove Counseling Collaborative, Pllc 6255 Towncenter Dr Ste 886 Clemmons NC 27012-9376 Ph: (336) 391-2803 | Alder Grove Counseling Collaborative, Pllc 5939 Frye Bridge Rd Clemmons NC 27012-9600 Ph: (336) 391-2803 |
| NPI Number | 1053140541 |
|---|---|
| Provider Enumeration Date | 07/31/2024 |
| Last Update Date | 07/31/2024 |
| Certification Date | 07/31/2024 |
| Medicare PECOS PAC ID | 2860917341 |
|---|---|
| Medicare Enrollment ID | O20250416003907 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053140541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Brian J Mccarthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336461813 PECOS PAC ID: 3072644228 Enrollment ID: I20100701000592 |
| Provider Name | Rebecca Stevens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740782507 PECOS PAC ID: 8527416080 Enrollment ID: I20231122001971 |
| Provider Name | Alison Turner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295111409 PECOS PAC ID: 8224486352 Enrollment ID: I20231129002203 |
| Provider Name | Cheryl Denine Goldberg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891831277 PECOS PAC ID: 7315398237 Enrollment ID: I20240104003507 |
| Provider Name | Antonia Glasco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144833302 PECOS PAC ID: 4981047305 Enrollment ID: I20240213000839 |
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