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Organization
LIFE MATRIX NC PLLC
Active
Organization
LIFE MATRIX NC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA M JOHNSON LCSW (CLINICAL DIRECTOR)
(910) 797-7354
Entity
Organization
Contact information
Practice address
100 HAY ST STE 701, FAYETTEVILLE, NC 28301-5487
(910) 444-1996
(800) 337-1933
Mailing address
100 HAY ST STE 701, FAYETTEVILLE, NC 28301-5487
(910) 797-7354
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
171400000X
Health & Wellness Coach
—
NULL
171400000X
Health & Wellness Coach
—
—
Other
Enumeration date
11/15/2018
Last updated
10/03/2023
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