| Free2bu Therapeutic Services Pllc | |
|
146 Ridge Rd Marston NC 28363-8532 | |
| (910) 212-7634 | |
| Not Available |
| Full Name | Free2bu Therapeutic Services Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 146 Ridge Rd, Marston, North Carolina |
| Authorized Official Name and Position | Kenyetta L Cooper (OWNER) |
| Authorized Official Contact | 4047216274 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Free2bu Therapeutic Services Pllc 500 Westover Dr # 16210 Sanford NC 27330-8941 Ph: (910) 212-7634 | Free2bu Therapeutic Services Pllc 146 Ridge Rd Marston NC 28363-8532 Ph: (910) 212-7634 |
| NPI Number | 1295445716 |
|---|---|
| Provider Enumeration Date | 11/28/2022 |
| Last Update Date | 11/28/2022 |
| Certification Date | 11/26/2022 |
| Medicare PECOS PAC ID | 2860862240 |
|---|---|
| Medicare Enrollment ID | O20221229000448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295445716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kenyetta L Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124687058 PECOS PAC ID: 5991183006 Enrollment ID: I20220601003109 |
Premier Counseling Group Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Stroman Rd, Marston, NC 28363 Phone: 585-967-8396 Fax: 910-491-9715 |