Healthcare Provider Details

I. General information

NPI: 1326951583
Provider Name (Legal Business Name): MY RESILIENT LIFE COACHING AND CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PARK OFFICES DR
DURHAM NC
27713-2844
US

IV. Provider business mailing address

600 PARK OFFICES DR
DURHAM NC
27713-2844
US

V. Phone/Fax

Practice location:
  • Phone: 828-552-0401
  • Fax:
Mailing address:
  • Phone: 828-552-0401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. STEPHANIE JEAN JONES
Title or Position: OWNER/ CLINICAL CONSULTANT
Credential: LCSW, MSW
Phone: 828-552-0401