| Providence Counseling Services | |
|
1401 Ravensthorpe Dr Fuquay Varina NC 27526-7714 | |
| (919) 924-1221 | |
| Not Available |
| Full Name | Providence Counseling Services |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1401 Ravensthorpe Dr, Fuquay Varina, North Carolina |
| Authorized Official Name and Position | Sarah Anne Lanza (PARTNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 9199241221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Counseling Services 1600 Spennymore Rd Raleigh NC 27603-9234 Ph: (919) 772-4490 | Providence Counseling Services 1401 Ravensthorpe Dr Fuquay Varina NC 27526-7714 Ph: (919) 924-1221 |
| NPI Number | 1972825867 |
|---|---|
| Provider Enumeration Date | 02/19/2010 |
| Last Update Date | 02/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972825867 | NPI | - | NPPES |
| 6103669 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 6595 (North Carolina) | Primary |
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