NPIMap

Organization Active NPI

Life Skills Counseling, PLLC

  • Community/Behavioral Health Agency
  • Wake Forest, NC
National Provider Identifier
1396945309
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL092635 Issued in NC
Legal business name
LIFE SKILLS COUNSELING, PLLC
Practice address
500 Wait Ave Ste 4
Wake Forest, NC 27587-2779
Phone
(919) 562-4659
Fax
(919) 562-4728
NPI assigned
Jul 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tammy Worthington
Title
Quality Services Director
Phone
(919) 833-2544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL092635 NC Primary

Addresses

Primary practice location

500 Wait Ave Ste 4
Wake Forest, NC 27587-2779

Mailing address

204 N Person St
Raleigh, NC 27601-1047
Phone (919) 833-2544

Other identifiers 3

IdentifierTypeStateIssuer
8300584MedicaidNC
8300584GMedicaidNC
8300584HMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Life Skills Counseling PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

500 Wait Ave
Ste 4
Wake Forest, NC 27587
Phone (919) 562-4659

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1396945309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N PERSON ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011047",
            "telephone_number": "919-833-2544",
            "fax_number": "919-833-0939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WAIT AVE STE 4",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872779",
            "telephone_number": "919-562-4659",
            "fax_number": "919-562-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SKILLS COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "WORTHINGTON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "QUALITY SERVICES DIRECTOR",
        "authorized_official_telephone_number": "919-833-2544"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL092635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300584",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300584G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300584H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.