Healthcare Provider Details

I. General information

NPI: 1285235382
Provider Name (Legal Business Name): FAITH FIRST CHRISTIAN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2020
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 N MAIN ST.
WALNUT COVE NC
27052
US

IV. Provider business mailing address

PO BOX 11321
WINSTON SALEM NC
27116-1321
US

V. Phone/Fax

Practice location:
  • Phone: 336-310-6727
  • Fax: 336-228-4321
Mailing address:
  • Phone: 336-310-6727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MICHELE ROBIN HAIRSTON
Title or Position: PRACTICE OWNER
Credential:
Phone: 336-310-6727