Providence Counseling Services, Pllc | |
1401 Ravensthorpe Dr Fuquay Varina NC 27526-7714 | |
(919) 924-1221 | |
(888) 470-4610 |
Full Name | Providence Counseling Services, Pllc |
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Speciality | Community/behavioral Health |
Location | 1401 Ravensthorpe Dr, Fuquay Varina, North Carolina |
Authorized Official Name and Position | Sarah Anne Lanza (CLINICAL DIRECTOR) |
Authorized Official Contact | 9199241221 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Providence Counseling Services, Pllc 1401 Ravensthorpe Dr Fuquay Varina NC 27526-7714 Ph: (919) 924-1221 | Providence Counseling Services, Pllc 1401 Ravensthorpe Dr Fuquay Varina NC 27526-7714 Ph: (919) 924-1221 |
NPI Number | 1891087516 |
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Provider Enumeration Date | 05/12/2011 |
Last Update Date | 05/12/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891087516 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 6595 (North Carolina) | Primary |
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