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Organization
LIFE FOUNDATIONS WELLNESS AND SUPPORTIVE COUNSELING SERVICES, LLC.
Active
Organization
LIFE FOUNDATIONS WELLNESS AND SUPPORTIVE COUNSELING SERVICES, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DIETRIX URQUHART (EXECUTIVE DIRECTOR)
(919) 949-8539
Entity
Organization
Contact information
Practice address
1910 SEDWICK RD BLDG 400, DURHAM, NC 27713-7807
(919) 949-8539
Mailing address
1910 SEDWICK RD BLDG 400, DURHAM, NC 27713-7807
(919) 949-8539
(919) 949-8539
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1622
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1622
NC
101YM0800X
Mental Health Counselor
1622
NC
Other
Enumeration date
02/14/2011
Last updated
06/04/2012
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