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Organization
REVITALIZE COUNSELING, PLLC
Active
Organization
REVITALIZE COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY CRAFT LCSW (OWNER)
(919) 357-8832
Entity
Organization
Contact information
Practice address
431 WATERVILLE RD, REALEIGH, NC 27603
(919) 357-8832
(919) 336-5134
Mailing address
1220 TIMBER DR E # 1033, GARNER, NC 27529-6917
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447727607
—
NC
01
—
C012367
LCSW
NC
Enumeration date
12/01/2021
Last updated
12/01/2021
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