| Evolving Life Counseling And Psychotherapy Pllc | |
|
3622 Morganton Rd Ste B Fayetteville NC 28303-4967 | |
| (910) 212-4441 | |
| (844) 965-9504 |
| Full Name | Evolving Life Counseling And Psychotherapy Pllc |
|---|---|
| Speciality | Counselor |
| Location | 3622 Morganton Rd Ste B, Fayetteville, North Carolina |
| Authorized Official Name and Position | Whitney Zaneta Gatling (OWNER) |
| Authorized Official Contact | 9102124441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolving Life Counseling And Psychotherapy Pllc Po Box 315 Durham NC 27702-0315 Ph: (910) 212-4441 | Evolving Life Counseling And Psychotherapy Pllc 3622 Morganton Rd Ste B Fayetteville NC 28303-4967 Ph: (910) 212-4441 |
| NPI Number | 1013575141 |
|---|---|
| Provider Enumeration Date | 06/04/2019 |
| Last Update Date | 12/14/2021 |
| Certification Date | 12/14/2021 |
| Medicare PECOS PAC ID | 8921491853 |
|---|---|
| Medicare Enrollment ID | O20220216002592 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013575141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Michele Annette Girard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609265099 PECOS PAC ID: 4688959059 Enrollment ID: I20170327001994 |
| Provider Name | Whitney Zaneta Gatling |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164844338 PECOS PAC ID: 6103219035 Enrollment ID: I20240110001273 |
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