Healthcare Provider Details

I. General information

NPI: 1609182039
Provider Name (Legal Business Name): FAMILY SOLUTIONS COUNSELING, PLLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2010
Last Update Date: 08/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 CAMPUS DR
WARRENTON NC
27589-8601
US

IV. Provider business mailing address

605 VIGO CT
ROLESVILLE NC
27571-9340
US

V. Phone/Fax

Practice location:
  • Phone: 919-306-4815
  • Fax: 919-761-9446
Mailing address:
  • Phone: 919-306-4815
  • Fax: 919-761-9446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number675
License Number StateNC

VIII. Authorized Official

Name: MRS. MELISSA L ELLIOTT
Title or Position: THERAPIST
Credential: M.ED, LMFT
Phone: 919-306-4815