KINGDOM CREATIVE COUNSELING PLLC NPI 1700313780

NPI Information

NPI: 1700313780
Provider Name: KINGDOM CREATIVE COUNSELING PLLC
Classification: Counselor - 101YM0800X
Specialization: Mental Health
Entity Type: Organization
Former Legal Business Name: SAMARIA M COLBERT
Address: 1050 REVOLUTION MILL DR STE 2
GREENSBORO, NC
ZIP 27405
Phone: (336) 543-0159

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NPI Details

KINGDOM CREATIVE COUNSELING PLLC is a mental health counselor in Greensboro, NC. KINGDOM CREATIVE COUNSELING PLLC NPI is 1700313780. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Samaria M Colbert.

The provider's business location address is:

1050 REVOLUTION MILL DR STE 2
GREENSBORO, NC
ZIP 27405-053
Phone: (336) 543-0159
Fax: (336) 663-2906

The provider's authorized official is Samaria M Colbert .
The authorized official title is Owner and has the following contact phone number (336) 543-0159.

The enumeration date for this NPI number is 5/22/2017 and was last updated on 12/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	C007049	NORTH CAROLINA	Yes
2	101YP2500X	Counselor	Professional	C007049	NORTH CAROLINA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1699077396	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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