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Organization
VALLEY CENTER FOR LIFE ENRICHMENT, PLLC
Active
Organization
VALLEY CENTER FOR LIFE ENRICHMENT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENNA CARPENTER LCMHCS (OWNER)
(252) 676-6636
Entity
Organization
Contact information
Practice address
600 JACKSON ST STE B, ROANOKE RAPIDS, NC 27870-2646
(252) 308-0744
(252) 308-0092
Mailing address
600 JACKSON ST STE B, ROANOKE RAPIDS, NC 27870-2646
(252) 676-6636
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
NC
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
03/16/2012
Last updated
10/14/2022
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