Organization
YOUR STORY REWRITTEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CERISSA CARROLL PAYMENT RHODES LCSW (OWENER)
(808) 375-0074
Entity
Organization
Contact information
Practice address
1241 N ROAD ST, ELIZABETH CITY, NC 27909-3335
(252) 368-9124
Mailing address
1241 N ROAD ST, ELIZABETH CITY, NC 27909-3335
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/15/2023
Last updated
08/28/2023
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