| Relax And Release Therapeutic Services, Pllc | |
|
1613 Owen Dr Ste B Fayetteville NC 28304-3425 | |
| (910) 491-8934 | |
| (910) 491-7119 |
| Full Name | Relax And Release Therapeutic Services, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1613 Owen Dr Ste B, Fayetteville, North Carolina |
| Authorized Official Name and Position | Tabitha Foster (OWNER/MANAGER) |
| Authorized Official Contact | 9107034640 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Relax And Release Therapeutic Services, Pllc 1613 Owen Dr Ste B Fayetteville NC 28304-3425 Ph: (910) 491-8934 | Relax And Release Therapeutic Services, Pllc 1613 Owen Dr Ste B Fayetteville NC 28304-3425 Ph: (910) 491-8934 |
| NPI Number | 1790388775 |
|---|---|
| Provider Enumeration Date | 11/20/2020 |
| Last Update Date | 01/22/2024 |
| Certification Date | 01/22/2024 |
| Medicare PECOS PAC ID | 2062879851 |
|---|---|
| Medicare Enrollment ID | O20230609002162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790388775 | NPI | - | NPPES |
| 1966176 | Other | NC | WELLCARE |
| 5635345 | Other | NC | CIGNA |
| 614937000 | Other | NC | OWCP |
| 19GHD | Other | NC | BLUE CROSS BLUE SHIELD |
| 601049373 | Other | NC | MAGELLAN |
| Provider Name | Tabitha I Foster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982084729 PECOS PAC ID: 8325313950 Enrollment ID: I20171009001171 |
| Provider Name | Latonya L. Crumwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467198721 PECOS PAC ID: 1456797596 Enrollment ID: I20240311003640 |
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