MEDICARE: FLOURISH COUNSELING AND CONSULTING, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	11294	NC

General Provider Information

NPI Number	:	1619415932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLOURISH COUNSELING AND CONSULTING, PLLC

Provider Business Mailing Address
First Line	:	2525 RAEFORD RD
Second Line	:	STE B
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28305-5091
Country	:	US
Telephone Number	:	910-764-6112
Fax Number	:	910-491-8902

Provider Business Practice Location Address
First Line	:	2525 RAEFORD RD
Second Line	:	STE B
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28305-5091
Country	:	US
Telephone Number	:	910-764-6112
Fax Number	:	910-491-8902

Authorized Official
Title or Position	:	OWNER, THERAPIST
Name	:	JERI STRONG
Credential	:	LPC, LMFT
Telephone Number	:	910-764-6112

Provider Enumeration Date	:	02/07/2017
Last Update Date	:	02/07/2017

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