Healthcare Provider Details

I. General information

NPI: 1346729134
Provider Name (Legal Business Name): FLAHERTY COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2018
Last Update Date: 08/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 CHAPEL HILL RD
SPRING LAKE NC
28390-2140
US

IV. Provider business mailing address

88 COTTSWOLD LN
SPRING LAKE NC
28390-7053
US

V. Phone/Fax

Practice location:
  • Phone: 910-916-7881
  • Fax: 910-436-5343
Mailing address:
  • Phone: 203-258-2571
  • Fax: 910-436-5343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC006317
License Number StateNC

VIII. Authorized Official

Name: MRS. LYNSEY VANGHEL FLAHERTY
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: MSW, LCSW
Phone: 203-258-2571