Healthcare Provider Details

I. General information

NPI: 1770404576
Provider Name (Legal Business Name): FAYETTEVILLE COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 FIELDS RD
FAYETTEVILLE NC
28312-7190
US

IV. Provider business mailing address

2140 FIELDS RD
FAYETTEVILLE NC
28312-7190
US

V. Phone/Fax

Practice location:
  • Phone: 910-574-0792
  • Fax:
Mailing address:
  • Phone: 910-574-0792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. CASEY DURWOOD GROOVER
Title or Position: OWNER
Credential: LCMHC
Phone: 910-574-0792