MEDICARE: DR. FAITH SPEAKS PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP1600X	Pastoral Counselor
4	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1093350506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FAITH SPEAKS PH.D.

Provider Business Mailing Address
First Line	:	730 CHESWICK AVE
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-7079
Country	:	US
Telephone Number	:	276-790-8006
Fax Number	:

Provider Business Practice Location Address
First Line	:	730 CHESWICK AVE
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-7079
Country	:	US
Telephone Number	:	276-790-8006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2019
Last Update Date	:	01/27/2021

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Directions to “ DR. FAITH SPEAKS PH.D.” Practice Location

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