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General NPI Number Information
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NPI Number | 1134410327
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Entity Type | Organization
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Legal Business Name | POSITIVE PROGRESS SERVICES CORP.
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Dates
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Enumeration Date | 04/22/2011
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Last Update Date | 04/22/2011
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Provider Practice Location Address
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Address Line | 305 E 3RD ST SUITE #5
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City | PEMBROKE
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State | NC
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Zip | 28372-7991
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Country | US
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Telephone | 910-521-7461
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Fax | 910-521-7463
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Provider Business Mailing Address
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Address Line | 305 E 3RD ST STE 5
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City | PEMBROKE
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State | NC
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Zip | 28372-7991
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Country | US
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Telephone | 910-521-7461
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Fax | 910-521-7463
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MRS. LORIE A HAMMONDS
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Credential | QP
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Telephone | 910-521-7461
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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 | MHL-078-249
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License Number State | NC
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