=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740724459
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BE STILL COUNSELING, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/14/2016
-----------------------------------------------------
Last Update Date | 12/14/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1218 W NORTHWOOD ST
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27408-8017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-707-4682
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1218 W NORTHWOOD ST
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27408-8017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-707-4682
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED PROFESSIONAL COUNSELOR
-----------------------------------------------------
Name | MRS. RACHEL SUZANNE HUTTO
-----------------------------------------------------
Credential | MS, ED.S, LPC
-----------------------------------------------------
Telephone | 803-707-4682
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 7787
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------