Healthcare Provider Details

I. General information

NPI: 1033040639
Provider Name (Legal Business Name): RESTORED PATH THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 THAGGARD LN
PARKTON NC
28371-6500
US

IV. Provider business mailing address

97 THAGGARD LN
PARKTON NC
28371-6500
US

V. Phone/Fax

Practice location:
  • Phone: 910-302-8648
  • Fax: 910-312-5146
Mailing address:
  • Phone: 910-302-8648
  • Fax: 910-312-5146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TAMI JO MORLOCK
Title or Position: OWNER
Credential: LCSW
Phone: 910-302-8648