| The Intentional Mind Counseling Services, P.l.l.c | |
|
4114 Oconnell St Indian Trail NC 28079-6792 | |
| (704) 312-0532 | |
| Not Available |
| Full Name | The Intentional Mind Counseling Services, P.l.l.c |
|---|---|
| Speciality | Counselor |
| Location | 4114 Oconnell St, Indian Trail, North Carolina |
| Authorized Official Name and Position | David Jerome Lewis (OWNER) |
| Authorized Official Contact | 9107502682 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Intentional Mind Counseling Services, P.l.l.c 4114 Oconnell St Indian Trail NC 28079-6792 Ph: (704) 312-0532 | The Intentional Mind Counseling Services, P.l.l.c 4114 Oconnell St Indian Trail NC 28079-6792 Ph: (704) 312-0532 |
| NPI Number | 1417743964 |
|---|---|
| Provider Enumeration Date | 04/18/2025 |
| Last Update Date | 04/18/2025 |
| Certification Date | 04/18/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417743964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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