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General NPI Number Information
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NPI Number | 1285235382
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Entity Type | Organization
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Legal Business Name | FAITH FIRST CHRISTIAN COUNSELING
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 530 N MAIN ST
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City | WALNUT COVE
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State | NC
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Zip | 27052-9247
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Country | US
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Telephone | 336-310-6727
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11321
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City | WINSTON SALEM
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State | NC
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Zip | 27116-1321
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Country | US
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Telephone | 336-310-6727
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Fax |
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Authorized Official
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Title or Position | OWNER/EMPLOYEE
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Name | MICHELE HAIRSTON
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Credential | LCMHC
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Telephone | 336-310-6727
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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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