Healthcare Provider Details

I. General information

NPI: 1316879844
Provider Name (Legal Business Name): A ROAD LESS TRAVELED COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 CHRIST SCHOOL RD
ARDEN NC
28704-8320
US

IV. Provider business mailing address

110 CHRIST SCHOOL RD
ARDEN NC
28704-8320
US

V. Phone/Fax

Practice location:
  • Phone: 859-494-7166
  • Fax:
Mailing address:
  • Phone: 859-494-7166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TYLER LEE MUDD
Title or Position: LCMHC/OWNER
Credential: LCMHC
Phone: 859-494-7166