The Tree of Life Counseling Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

THE TREE OF LIFE COUNSELING CENTER

Practice address

2402 S Miami Blvd Ste 108
Durham, NC 27703-4928

Phone

(919) 696-0072

NPI assigned

Nov 30, 2020

Last updated

Nov 30, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tatisha Fauntleroy, LPC

Title

Owner/Therapist

Phone

(919) 696-0072

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606694400000",
    "number": "1750985701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 S MIAMI BLVD STE 108",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277034928",
            "telephone_number": "919-696-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 S MIAMI BLVD STE 108",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277034928",
            "telephone_number": "919-696-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE TREE OF LIFE COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "FAUNTLEROY",
        "authorized_official_first_name": "TATISHA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "919-696-0072",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "DURHAM",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2402 S Miami Blvd Ste 108",
            "city": "Durham",
            "state": "NC",
            "country_code": "US",
            "postal_code": "277034928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• The North Carolina Institute for Health Technologies, Inc (Carolina Healthcare Network)
• The Perfect Nurse, LLC
• The Pickett House Family Care Home
• The Springs
• The Tenderfire Project PLLC
• The United Methodist Retirement Homes, Incorporated
• The United Methodist Retirement Homes, Incorporated (Croasdaile Village Home Care)
• The United Methodist Retirement Homes, Incorporated (Croasdaile Village)
• The Village-a Comprehensive Human Service Network
• The Wavewatch Group, Inc.

• Mental Health Counselor in Durham, NC
• Providers in Durham, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.