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General NPI Number Information
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NPI Number | 1417355561
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Entity Type | Organization
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Legal Business Name | FAMILY SOLUTIONS & WELLNESS CENTER
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Dates
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Enumeration Date | 12/05/2014
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Last Update Date | 12/05/2014
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Provider Practice Location Address
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Address Line | 929 SHELLBROOK CT APT 6
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City | RALEIGH
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State | NC
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Zip | 27609-4224
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Country | US
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Telephone | 703-376-1571
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Fax |
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Provider Business Mailing Address
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Address Line | 929 SHELLBROOK CT APT 6
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City | RALEIGH
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State | NC
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Zip | 27609-4224
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Country | US
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Telephone | 703-376-1571
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Fax |
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Authorized Official
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Title or Position | THERAPIST/MANAGER
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Name | ERIN LEWIS
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Credential | LMFT
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Telephone | 703-376-1571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1572
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License Number State | NC
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