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General NPI Number Information
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NPI Number | 1912766411
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Entity Type | Individual
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Provider Name | ELIZABETH TICE LCMHCA
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Gender | Female
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 8705 GROUSE RUN LN
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-6076
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Country | US
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Telephone | 910-745-7527
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Fax |
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Provider Business Mailing Address
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Address Line | 8705 GROUSE RUN LN
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-6076
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Country | US
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Telephone | 360-980-1057
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Fax | 919-205-9919
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | A19566
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License Number State | NC
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