| Living Waters Counseling, Pllc | |
|
1700 E Ash St Suite 303 Goldsboro NC 27530-4097 | |
| (919) 581-7072 | |
| (919) 330-5121 |
| Full Name | Living Waters Counseling, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1700 E Ash St, Goldsboro, North Carolina |
| Authorized Official Name and Position | Tracie L Hillard (OWNER) |
| Authorized Official Contact | 9195817072 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Waters Counseling, Pllc 2822 Cashwell Dr Number 214 Goldsboro NC 27534-4302 Ph: (919) 581-7072 | Living Waters Counseling, Pllc 1700 E Ash St Suite 303 Goldsboro NC 27530-4097 Ph: (919) 581-7072 |
| NPI Number | 1689935264 |
|---|---|
| Provider Enumeration Date | 05/31/2012 |
| Last Update Date | 05/31/2012 |
| Medicare PECOS PAC ID | 3072957117 |
|---|---|
| Medicare Enrollment ID | O20240216003168 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689935264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Tracie Lynn Hillard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376735928 PECOS PAC ID: 4981048022 Enrollment ID: I20240216003381 |
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