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Organization

LSBF PROFESSIONAL COUNSELING SERVICES, PLLC

Active
Other names
Elemental Care Services, Ellie Mental Health
Organization subpart
No

Provider details

NPI number
Authorized official
BRYANT FORIEST (CEO)
(336) 608-4037
Entity
Organization

Contact information

Practice address
250 EXECUTIVE PARK BLVD STE 120, WINSTON SALEM, NC 27103-1534
(336) 266-3289
Mailing address
250 EXECUTIVE PARK BLVD STE 120, WINSTON SALEM, NC 27103-1534
(336) 608-4037
(336) 893-0569

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
251S00000X
Community/Behavioral Health Agency
Primary
261Q00000X
Clinic/Center
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
02/21/2023
Last updated
06/30/2026
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