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General NPI Number Information
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NPI Number | 1124255179
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Entity Type | Organization
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Legal Business Name | ELITE PERSPECTIVES COUNSELING SERVICES
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Dates
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Enumeration Date | 06/17/2009
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Last Update Date | 06/22/2009
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Provider Practice Location Address
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Address Line | 4617 BENT GRASS DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28312-9124
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Country | US
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Telephone | 910-822-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 4617 BENT GRASS DRIVE FAYETTEVILLE
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City | FAYETTEVILLE
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State | NC
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Zip | 28312
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY SMITH WILLIAMS
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Credential | LPC
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Telephone | 910-822-9700
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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 | 4743
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License Number State | NC
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