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General NPI Number Information
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NPI Number | 1386161743
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Entity Type | Organization
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Legal Business Name | RELEAF COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 08/27/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 150 PROVIDENCE RD STE 101
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City | CHAPEL HILL
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State | NC
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Zip | 27514-2208
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Country | US
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Telephone | 919-391-8284
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Fax |
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Provider Business Mailing Address
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Address Line | 150 PROVIDENCE RD STE 101
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City | CHAPEL HILL
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State | NC
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Zip | 27514-2208
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Country | US
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Telephone | 919-391-8284
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | LORENA GONZALEZ VANDERSAND
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Credential | PHD
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Telephone | 919-391-8284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 4041
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License Number State | NC
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