MEDICARE: ONE TOUCH PASTORAL COUNSELING

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1871996793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE TOUCH PASTORAL COUNSELING

Provider Business Mailing Address
First Line	:	110 WOODSIDE RD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-1129
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 WOODSIDE RD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-1129
Country	:	US
Telephone Number	:	252-302-0700
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER, CEO
Name	:	MRS. TANISHA JOHNSON
Credential	:	M.A.R, MDIV.
Telephone Number	:	252-258-3843

Provider Enumeration Date	:	10/06/2014
Last Update Date	:	10/06/2014

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