Individual
LATOYA FAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCASA
Contact information
Practice address
121 CAROLINA FOREST DRIVE, GOLDSBORO, NC 27534
(919) 394-1118
Mailing address
121 CAROLINA FOREST DRIVE, GOLDSBORO, NC 27534
(919) 252-9622
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-24856
NC
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
P010851
NC
Other
Enumeration date
12/19/2016
Last updated
07/25/2022
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