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General NPI Number Information
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NPI Number | 1801753371
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Entity Type | Organization
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Legal Business Name | PREMEDITATED PROSPERITY COUNSELING AND CONSULTING SERVICES, PLLC
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 905 MCLEAN ST
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City | RAEFORD
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State | NC
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Zip | 28376-2350
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Country | US
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Telephone | 910-309-8053
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Fax |
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Provider Business Mailing Address
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Address Line | 905 MCLEAN ST
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City | RAEFORD
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State | NC
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Zip | 28376-2350
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Country | US
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Telephone | 910-309-8053
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Fax |
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Authorized Official
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Title or Position | CLINICIAN/OWNER
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Name | AMY LOVE
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Credential | LCSW
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Telephone | 910-309-8053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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