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General NPI Number Information
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NPI Number | 1720573215
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Entity Type | Organization
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Legal Business Name | TOOLS4LIFE LLC
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 03/08/2019
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Provider Practice Location Address
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Address Line | 103 E. 8TH STREET 103
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City | SOUTHPORT
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State | NC
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Zip | 28461-3523
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Country | US
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Telephone | 910-987-6491
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Fax | 910-363-4075
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Provider Business Mailing Address
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Address Line | 103 HOLLY DR
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City | SOUTHPORT
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State | NC
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Zip | 28461-2709
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Country | US
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Telephone | 910-366-2946
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Fax | 910-363-4075
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Authorized Official
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Title or Position | OWNER/EXECUTIVE DIRECTOR
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Name | MRS. REBECCA JANE HEDGECOCK
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Credential | LPC
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Telephone | 910-987-6491
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | NC
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