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General NPI Number Information
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NPI Number | 1134030695
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Entity Type | Organization
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Legal Business Name | PRENTICE COUNSELING & ASSOCIATES, PLLC
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Dates
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Enumeration Date | 09/14/2026
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Last Update Date | 09/14/2026
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Provider Practice Location Address
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Address Line | 3972 US HIGHWAY 17 BUS E STE I2
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City | BOLIVIA
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State | NC
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Zip | 28422-8698
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Country | US
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Telephone | 704-960-7050
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Fax | 910-946-6197
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Provider Business Mailing Address
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Address Line | 3972 US HIGHWAY 17 BUS E STE I2
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City | BOLIVIA
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State | NC
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Zip | 28422-8698
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Country | US
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Telephone | 704-960-7050
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Fax | 910-946-6197
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Authorized Official
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Title or Position | OWNER
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Name | TY PRENTICE
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Credential | MA, NCC
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Telephone | 704-960-7050
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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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