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General NPI Number Information
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NPI Number | 1467747030
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Entity Type | Organization
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Legal Business Name | FOSTERING REAL CHANGE COUNSELING SERVICES, INC.
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 06/13/2011
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Provider Practice Location Address
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Address Line | 220 3RD AVE W SUITE A
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City | HENDERSONVILLE
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State | NC
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Zip | 28739-4330
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Country | US
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Telephone | 828-376-0000
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Fax | 828-376-0000
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Provider Business Mailing Address
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Address Line | PO BOX 1426
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City | HENDERSONVILLE
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State | NC
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Zip | 28793-1426
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Country | US
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Telephone | 828-376-0000
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Fax | 828-376-0000
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. DAYLE BENEDETTI
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Credential | L.P.C.
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Telephone | 828-376-0000
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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 | 7302
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License Number State | NC
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