Living Well International Center, PC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

7229 Issued in NC

Legal business name

LIVING WELL INTERNATIONAL CENTER, PC

Practice address

5710 Six Forks Rd
Raleigh, NC 27609-8617

Phone

(919) 673-4221

Fax

(919) 301-8957

NPI assigned

Jan 28, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Angela Ore Green, LPCNPI 1306082862

Title

Counselor

Phone

(919) 673-4221

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angela O Green, LPC

  • Professional Counselor
  • Raleigh, NC
  • NPI 1306082862
  Authorized official Same address or phone

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

{
    "created_epoch": "1264636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423440000000",
    "number": "1417288580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 PINEHALL WYND",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276045825",
            "telephone_number": "919-673-4221",
            "fax_number": "919-301-8957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276098617",
            "telephone_number": "919-673-4221",
            "fax_number": "919-301-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL INTERNATIONAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-28",
        "last_updated": "2015-02-09",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "ORE",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "919-673-4221",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "7229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104087",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.