Space to Heal Counseling and Wellness, PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SPACE TO HEAL COUNSELING AND WELLNESS, PLLC

Practice address

713 N Eugene St
Greensboro, NC 27401-1621

Phone

(336) 585-7188

NPI assigned

Sep 10, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carla Kucinski, LPCA, NCC

Title

Owner/Counselor

Phone

(336) 402-4695

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568073600000",
    "number": "1164071213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 COLLEGE RD UNIT 304",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274105385",
            "telephone_number": "336-402-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 N EUGENE ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011621",
            "telephone_number": "336-585-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE TO HEAL COUNSELING AND WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A",
        "authorized_official_last_name": "KUCINSKI",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "OWNER/COUNSELOR",
        "authorized_official_telephone_number": "336-402-4695",
        "authorized_official_credential": "LPCA, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Dare Southern Morris, LCSW
• Barry William Southern, R.PH.
• Judy Southern
• Brandon Sowell, MD
• Rebekah Sowers, PHARMD
• Linda D. Spagnola, RN, BSN, CDE
• Jeniffer Spagnolo
• David Sevier Spainhour, P.A.
• Isaac Samuel Sparks, D.O.
• Linsey Grissom Sparks, LCSWA

• Mental Health Counselor in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.