MEDICARE: GLOBAL OUTREACH TELEREHABILITATION

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	133V00000X	Registered Dietitian	L004636	NC
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	22354	NC
3	103K00000X	Behavior Analyst	1-17-27316	NC
4	1041C0700X	Clinical Social Worker	C010212	NC

General Provider Information

NPI Number	:	1720582588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOBAL OUTREACH TELEREHABILITATION

Provider Business Mailing Address
First Line	:	214 FAIRWAY DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28305-5502
Country	:	US
Telephone Number	:	910-491-1901
Fax Number	:	910-221-8294

Provider Business Practice Location Address
First Line	:	214 FAIRWAY DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28305-5502
Country	:	US
Telephone Number	:	910-491-8186
Fax Number	:	910-808-1042

Authorized Official
Title or Position	:	OWNER
Name	:	ROSALIND WOODS
Credential	:
Telephone Number	:	910-491-1901

Provider Enumeration Date	:	03/19/2018
Last Update Date	:	12/16/2025

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