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General NPI Number Information
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NPI Number | 1881788818
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Entity Type | Organization
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Legal Business Name | ENVISIONS OF LIFE LLC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 5 CENTERVIEW DR STE 110
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City | GREENSBORO
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State | NC
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Zip | 27407-3709
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Country | US
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Telephone | 336-887-0708
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Fax | 336-887-1085
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Provider Business Mailing Address
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Address Line | 5 CENTERVIEW DR STE 110
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City | GREENSBORO
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State | NC
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Zip | 27407-3709
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Country | US
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Telephone | 336-887-0708
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Fax | 336-887-1085
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARVA MATHIS
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Credential | BS,
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Telephone | 336-887-0708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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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 |
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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 |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | NC
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