| Amazing Space Counseling, Pllc | |
|
1220 N Main St Ste 103 High Point NC 27262-3100 | |
| (409) 504-5799 | |
| Not Available |
| Full Name | Amazing Space Counseling, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1220 N Main St Ste 103, High Point, North Carolina |
| Authorized Official Name and Position | Aleasha Mitchell (OWNER) |
| Authorized Official Contact | 4095045799 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amazing Space Counseling, Pllc 6465 Allendale Dr Archdale NC 27263-3832 Ph: () - | Amazing Space Counseling, Pllc 1220 N Main St Ste 103 High Point NC 27262-3100 Ph: (409) 504-5799 |
| NPI Number | 1962271080 |
|---|---|
| Provider Enumeration Date | 12/29/2023 |
| Last Update Date | 09/05/2024 |
| Certification Date | 09/05/2024 |
| Medicare PECOS PAC ID | 4284160839 |
|---|---|
| Medicare Enrollment ID | O20241206000828 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962271080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Aleasha Mitchell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417520693 PECOS PAC ID: 7810423464 Enrollment ID: I20241206000902 |
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