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General NPI Number Information
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NPI Number | 1164891149
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Entity Type | Organization
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Legal Business Name | LIFE WELLNESS COUNSELING PLLC
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Dates
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Enumeration Date | 09/19/2015
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 100 PAVILION WAY STE E
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-4560
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Country | US
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Telephone | 910-638-6748
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Fax | 910-725-0289
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Provider Business Mailing Address
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Address Line | 126 RACQUET LN
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City | PINEHURST
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State | NC
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Zip | 28374-7626
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Country | US
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Telephone | 252-619-5451
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Fax | 910-725-0289
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Authorized Official
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Title or Position | OWNER, PROVIDER
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Name | AMBER BANE SENERES
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Credential | LCMHC
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Telephone | 252-619-5451
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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 |
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License Number State |
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