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General NPI Number Information
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NPI Number | 1033169990
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Entity Type | Individual
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Provider Name | JEFF T FLOWERS LPC
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 09/28/2011
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Provider Practice Location Address
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Address Line | 824 GUM BRANCH RD STE B
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City | JACKSONVILLE
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State | NC
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Zip | 28540-6269
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Country | US
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Telephone | 910-265-2919
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Fax | 910-355-2427
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Provider Business Mailing Address
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Address Line | 111 BRIDGEWATER CT
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City | JACKSONVILLE
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State | NC
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Zip | 28546-7905
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Country | US
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Telephone | 910-265-2919
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Fax | 910-355-2427
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4282
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6904
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License Number State | NC
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