Organization
FAITHFUL LIVING FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE ROBIN HAIRSTON LCMHC (DIRECTOR)
(336) 310-6727
Entity
Organization
Contact information
Practice address
223 NORTH MAIN STREET, WALNUT COVE, NC 27952
(336) 310-6727
Mailing address
PO BOX 11321, WINSTON SALEM, NC 27116-1321
(336) 310-6727
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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