| Love Life Counseling Services, Pllc | |
|
212 Elm St Aberdeen NC 28315-2802 | |
| (910) 287-5430 | |
| Not Available |
| Full Name | Love Life Counseling Services, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 212 Elm St, Aberdeen, North Carolina |
| Authorized Official Name and Position | Rezell Gore (CEO/ CLINICAL SUPERVISOR) |
| Authorized Official Contact | 9102875430 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Love Life Counseling Services, Pllc Po Box 485 Red Springs NC 28377-0485 Ph: (910) 287-5430 | Love Life Counseling Services, Pllc 212 Elm St Aberdeen NC 28315-2802 Ph: (910) 287-5430 |
| NPI Number | 1497235626 |
|---|---|
| Provider Enumeration Date | 08/16/2018 |
| Last Update Date | 08/16/2018 |
| Medicare PECOS PAC ID | 3678818929 |
|---|---|
| Medicare Enrollment ID | O20190920000613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497235626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 20470 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | C010441 (North Carolina) | Primary |
| Provider Name | Rezell Gore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194126276 PECOS PAC ID: 4082929559 Enrollment ID: I20190926000314 |
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