Provider Demographics
NPI:1689198095
Name:21ST CENTURY COUNSELING, PLLC
Entity type:Organization
Organization Name:21ST CENTURY COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JONADAB
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:FRANCO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LCSW
Authorized Official - Phone:910-817-9181
Mailing Address - Street 1:304 E GREEN STREET
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-3423
Mailing Address - Country:US
Mailing Address - Phone:910-817-9181
Mailing Address - Fax:800-878-9353
Practice Address - Street 1:304 E GREENE ST
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-3423
Practice Address - Country:US
Practice Address - Phone:910-817-9181
Practice Address - Fax:800-878-9353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-27
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00569450Medicaid