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
721 TUCKER ST, RALEIGH, NC 27603-1248
(919) 833-8862
(919) 833-8595
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
MHL092636
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300583
—
NC
05
—
8300583G
—
NC
05
—
8300583H
—
NC
Enumeration date
07/19/2007
Last updated
07/19/2007
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