Renee Jacobsen Birch, LCMHC

Individual provider Active NPI Mental Health Counselor · Cornelius, NC

NPI 1194438820 · NPPES record last updated Dec 27, 2022

Key facts

NPI
1194438820
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
13968 (NC)
Practice address
17015 Kenton Dr
Cornelius, NC 28031-5661
Phone
(704) 970-2471
NPI assigned
Dec 27, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
13968NCMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 13968 NC Yes

Addresses

Primary practice location

17015 Kenton Dr
Cornelius, NC 28031-5661

Mailing address

9517 Guildbrook Rd
Davidson, NC 28036-9613
Phone (704) 970-2471

Other practice location 1

5950 Fairview Rd
Charlotte, NC 28210-3104
Phone (704) 970-2471

Other providers in Cornelius, NC

All providers in Cornelius, NC · Mental Health Counselor in North Carolina

Sources for this page

Verify at the official NPI Registry.