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Organization

LIVING WELL COUNSELING SERVICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EBONI AFFUM LCSW (CHIEF EXECUTIVE OFFICER)
(313) 410-1871
Entity
Organization

Contact information

Practice address
7312 HIHENGE CT, 7, RALEIGH, NC 27615-4313
(313) 410-1871
Mailing address
7312 HIHENGE CT, 7, RALEIGH, NC 27615-4313

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C007345
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1982913398
NC
Enumeration date
06/14/2015
Last updated
07/15/2015
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