# INDEPENDENCE COUNSELING AND CONSULTING SERVICES, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932445996
- **Authorized official:** TIFFANY SHAW LPC, NCC, LCAS (DIRECTOR)
- **Authorized official phone:** (910) 261-4635

## Contact information

- **Practice address:** 946 MOCKINGBIRD HILL RD, RAEFORD, NC 28376-6363
- **Practice address phone:** (910) 261-4635
- **Mailing address:** 946 MOCKINGBIRD HILL RD, RAEFORD, NC 28376-6363

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 7366 | NC | Yes |

## Other

- **Enumeration date:** 12/19/2012
- **Last updated:** 12/19/2012