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Organization
FOREVER HOPE, PLLC
Active
Organization
FOREVER HOPE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY D'ANDREA CHARLES LCSW (ORGANIZER/LICENSED THERAPIST)
(336) 793-5718
Entity
Organization
Contact information
Practice address
3000 BETHESDA PL STE 201, WINSTON SALEM, NC 27103-3324
(336) 793-5718
Mailing address
PO BOX 25653, WINSTON SALEM, NC 27114-5653
(336) 793-5718
(336) 790-6770
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568941326
NPI
NC
01
—
1790182251
NPI
NC
Enumeration date
01/25/2021
Last updated
07/02/2021
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