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Organization
PROVIDENCE HEALTHCARE SERVICES PLLC
Active
Organization
PROVIDENCE HEALTHCARE SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCY KENYA-TOLO MSW, LCSWA, LCASA (OWNER)
(910) 318-4958
Entity
Organization
Contact information
Practice address
404 FAIRLY ST # A, LAURINBURG, NC 28352-3612
(910) 318-4958
Mailing address
404 FAIRLY ST # A, LAURINBURG, NC 28352-3612
(910) 318-4958
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
06/19/2023
Last updated
11/30/2023
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