Organization
FAMILIES 1ST COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TOMEKA DAVIS SHAW LPC, NCC (EXECUTIVE DIRECTOR/OWNER)
(910) 797-5661
Entity
Organization
Contact information
Practice address
346 WAGONER DR, SUITE 106, FAYETTEVILLE, NC 28303-4680
(910) 864-0179
(910) 864-3162
Mailing address
346 WAGONER DR, SUITE 106, FAYETTEVILLE, NC 28303-4680
(910) 864-0179
(910) 864-3162
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7255
NC
101YP2500X
Professional Counselor
Primary
7255
NC
103T00000X
Psychologist
1596
NC
251S00000X
Community/Behavioral Health Agency
7255
NC
252Y00000X
Early Intervention Provider Agency
7255
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13857
BCBS
NC
01
—
151XR
BCBS
NC
01
—
437554
TRICARE
NC
05
—
6104094
—
NC
05
—
6107612
—
NC
Enumeration date
06/04/2009
Last updated
12/07/2010
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