Individual
NORMA MOODY FAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC
Contact information
Practice address
237 W PENNSYLVANIA AVE, SOUTHERN PINES, NC 28387-5430
(910) 725-1015
Mailing address
625 FAIRWAY DR, SOUTHERN PINES, NC 28387-2201
(910) 725-1086
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A8224
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67582H2142L2
—
NC
Enumeration date
02/10/2009
Last updated
05/09/2012
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