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Organization

PREMIER COUNSELING GROUP PLLC

Active
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Organization

PREMIER COUNSELING GROUP PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAVARES ANTWAN BOSTIC LCSW (PRESIDENT)
(585) 967-8396
Entity
Organization

Contact information

Practice address
201 STROMAN RD, MARSTON, NC 28363-9501
(585) 967-8396
(910) 491-9715
Mailing address
801 E BROAD AVE, STE 18, ROCKINGHAM, NC 28379-4383
(585) 967-8396
(910) 491-9715

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NULL

Other

Enumeration date
02/01/2017
Last updated
02/01/2017
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