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General NPI Number Information
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NPI Number | 1033897095
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Entity Type | Organization
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Legal Business Name | MOVING FORWARD INDIVIDUAL AND FAMILY THERAPY, PLLC
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 809 KATIE ST
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-2810
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Country | US
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Telephone | 910-489-3725
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Fax |
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Provider Business Mailing Address
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Address Line | 809 KATIE ST
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-2810
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Country | US
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Telephone | 910-489-3725
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL MENTAL HEALTH COU
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Name | MS. ANTOINETTE MORRIS
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Credential | LCMHC
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Telephone | 910-489-3725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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