Healthcare Provider Details

I. General information

NPI: 1528219433
Provider Name (Legal Business Name): DENISE FETTERS LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEEDEE ELIZABETH FETTERS LCMHC, LPCC, NCC

II. Dates (important events)

Enumeration Date: 10/09/2008
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7906 BROAD ST
RURAL HALL NC
27045-9335
US

IV. Provider business mailing address

7430 CRAIGBERRY CT
RURAL HALL NC
27045-9134
US

V. Phone/Fax

Practice location:
  • Phone: 336-594-0023
  • Fax:
Mailing address:
  • Phone: 330-594-0023
  • Fax: 855-941-0577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number16490
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0007999
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: