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Individual

ROLAND JIMMY PAULK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A.,CCC,LPC,LCASA

Contact information

Practice address
205 MEMORIAL DRIVE, PINEHURST, NC 28370-8712
(910) 295-6853
(910) 295-9183
Mailing address
284 EXECUTIVE PARK DR, SUITE 100, CONCORD, NC 28025-1894
(704) 939-1118
(704) 939-1173

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
8955
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
2836-A
NC

Other

Enumeration date
09/15/2011
Last updated
07/26/2013
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