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Organization
WORD OF LIFE OUTREACH OF CAPE FEAR, INC.
Active
Organization
WORD OF LIFE OUTREACH OF CAPE FEAR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERY A. JOHNSON BA (CEO)
(910) 547-8792
Entity
Organization
Contact information
Practice address
1510 JOHNS RD, AUGUSTA, GA 30904-4828
(910) 233-7550
(910) 371-5302
Mailing address
PO BOX 641, LELAND, NC 28451-0641
(910) 233-7550
(910) 371-5302
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
05/31/2009
Last updated
05/31/2009
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