Healthcare Provider Details

I. General information

NPI: 1821823204
Provider Name (Legal Business Name): BRIGHTER HORIZONS TREATMENT AND ASSESSMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 OWEN DR STE 202-4
FAYETTEVILLE NC
28304-1611
US

IV. Provider business mailing address

1830 OWEN DR STE 202-4
FAYETTEVILLE NC
28304-1611
US

V. Phone/Fax

Practice location:
  • Phone: 910-568-6239
  • Fax:
Mailing address:
  • Phone: 910-568-6239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: VIVIAN M DAVIS
Title or Position: OWNER/OUTPATIENT THERAPIST
Credential: LCAS, LCSWA, CCSI
Phone: 910-568-6239