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General NPI Number Information
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NPI Number | 1699005710
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Entity Type | Individual
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Provider Name | JACQUELINE PHILLIPS TRUITT M.A. LCMHC, LCAS
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Gender | Female
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 2817 ROCK MERRITT AVE
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City | FORT BRAGG
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State | NC
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Zip | 28310-8698
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Country | US
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Telephone | 910-908-6002
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Fax |
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Provider Business Mailing Address
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Address Line | 2817 ROCK MERRITT AVE STOP A
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City | FORT BRAGG
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State | NC
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Zip | 28310-5000
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Country | US
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Telephone | 919-824-9069
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 7726
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7726
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7726
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 7726
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License Number State | NC
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