Healthcare Provider Details

I. General information

NPI: 1942751763
Provider Name (Legal Business Name): SPAULDING SOLUTIONS COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2016
Last Update Date: 11/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 HOPE MILLS RD
FAYETTEVILLE NC
28304-4243
US

IV. Provider business mailing address

910 HOPE MILLS RD
FAYETTEVILLE NC
28304-4243
US

V. Phone/Fax

Practice location:
  • Phone: 910-425-2321
  • Fax:
Mailing address:
  • Phone: 910-745-9913
  • Fax: 910-679-6348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS20725
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberC009552
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC009552
License Number StateNC

VIII. Authorized Official

Name: AMBROSIA SPAULDING
Title or Position: CEO
Credential: LCSW, LCAS
Phone: 910-840-0424