Organization
LIFE SKILLS COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY WORTHINGTON (QUALITY SERVICES DIRECTOR)
(919) 833-2544
Entity
Organization
Contact information
Practice address
500 WAIT AVE STE 4, WAKE FOREST, NC 27587-2779
(919) 562-4659
(919) 562-4728
Mailing address
204 N PERSON ST, RALEIGH, NC 27601-1047
(919) 833-2544
(919) 833-0939
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL092635
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300584
—
NC
05
—
8300584G
—
NC
05
—
8300584H
—
NC
Enumeration date
07/19/2007
Last updated
07/19/2007
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