Healthcare Provider Details

I. General information

NPI: 1275448128
Provider Name (Legal Business Name): LIVE IN THE MOMENT COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 BROADVIEW AVE
LEXINGTON NC
27295-2013
US

IV. Provider business mailing address

5030 PETERS CREEK PKWY
WINSTON SALEM NC
27127-7276
US

V. Phone/Fax

Practice location:
  • Phone: 336-466-4136
  • Fax:
Mailing address:
  • Phone: 336-466-4136
  • 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: OLIVIA RALEA CUNDIFF
Title or Position: OWNER
Credential: LCMHCA
Phone: 336-466-4136