Provider Demographics
NPI:1548313547
Name:WESTERN CAROLINA COUNSELING SERVICES PA
Entity type:Organization
Organization Name:WESTERN CAROLINA COUNSELING SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:828-586-8700
Mailing Address - Street 1:103 SYLVAN HTS
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-2543
Mailing Address - Country:US
Mailing Address - Phone:828-586-8700
Mailing Address - Fax:828-586-1051
Practice Address - Street 1:103 SYLVAN HTS
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-2543
Practice Address - Country:US
Practice Address - Phone:828-586-8700
Practice Address - Fax:828-586-1051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3382101YP2500X
NC1322103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty