Provider Demographics
NPI:1730780446
Name:ARDENT PATH COUNSELING AND CLINICAL CONSULTATION
Entity type:Organization
Organization Name:ARDENT PATH COUNSELING AND CLINICAL CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:N
Authorized Official - Last Name:LIERSAPH
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:704-807-3768
Mailing Address - Street 1:1079 PEACHTREE LN
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-2160
Mailing Address - Country:US
Mailing Address - Phone:704-807-3768
Mailing Address - Fax:
Practice Address - Street 1:11230 CARMEL COMMONS BLVD STE 106
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3920
Practice Address - Country:US
Practice Address - Phone:704-807-3768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health