Healthcare Provider Details

I. General information

NPI: 1679323935
Provider Name (Legal Business Name): RUACH FAITH & COURAGE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2024
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 WINTERGREEN CIR
STATESVILLE NC
28677-2041
US

IV. Provider business mailing address

185 WINTERGREEN CIR
STATESVILLE NC
28677-2041
US

V. Phone/Fax

Practice location:
  • Phone: 704-929-0610
  • Fax:
Mailing address:
  • Phone: 704-929-0610
  • 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: DR. RHONDA FLOWERS-CORPENING
Title or Position: CEO
Credential: PH.D., LCSW
Phone: 704-929-0610