Provider Demographics
NPI:1154614238
Name:GUIDING LIVES COUNSELING AND WELLNESS CENTER
Entity type:Organization
Organization Name:GUIDING LIVES COUNSELING AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:NOBLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-439-1117
Mailing Address - Street 1:504 DEXTER ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6320
Mailing Address - Country:US
Mailing Address - Phone:252-439-1117
Mailing Address - Fax:252-439-1119
Practice Address - Street 1:504 DEXTER ST
Practice Address - Street 2:SUITE B
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6320
Practice Address - Country:US
Practice Address - Phone:252-439-1117
Practice Address - Fax:252-439-1119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC153592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty