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Organization
TREE OF LIFE COUNSELING, PLLC
Active
Organization
TREE OF LIFE COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANA GORDON WALTMAN MA (OWNER)
(336) 288-9190
Entity
Organization
Contact information
Practice address
5 OAK BRANCH DR STE H, GREENSBORO, NC 27407-2157
(336) 288-9190
(336) 450-4318
Mailing address
5 OAK BRANCH DR STE H, GREENSBORO, NC 27407-2157
(336) 288-9190
(336) 450-4318
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
7308
NC
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S7803
NORTH CAROLINA BOARD OF LICENSED CLINICAL MENTAL HEALTH COUNSELORS
NC
Enumeration date
04/10/2012
Last updated
08/26/2025
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