Organization
JODI PROVINCE COUNSELING SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI TILLEY PROVINCE (EXECUTIVE DIRECTOR)
(336) 818-0733
Entity
Organization
Contact information
Practice address
2587 PLEASANT RIDGE RD, STATE ROAD, NC 28676-9318
(336) 818-0733
Mailing address
1260 COLLEGE AVE, SUITE 1, WILKESBORO, NC 28697-2700
(336) 526-0073
(336) 526-0036
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/26/2015
Last updated
07/27/2023
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