Healthcare Provider Details

I. General information

NPI: 1114010055
Provider Name (Legal Business Name): CHOICES COUNSELING & RESOURCE CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N MAIN ST STE 300
MOUNT AIRY NC
27030-3867
US

IV. Provider business mailing address

201 N MAIN ST STE 300
MOUNT AIRY NC
27030-3867
US

V. Phone/Fax

Practice location:
  • Phone: 336-786-2053
  • Fax: 336-786-2198
Mailing address:
  • Phone: 336-786-2053
  • Fax: 336-786-2198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number0100005M
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3844
License Number StateNC

VIII. Authorized Official

Name: JOANNA H REFVEM
Title or Position: OWNER
Credential: LPC
Phone: 336-786-2053