Provider Demographics
NPI:1194997379
Name:TRANQUILITY COUNSELING SERVICES
Entity type:Organization
Organization Name:TRANQUILITY COUNSELING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:TOWNSEND
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-751-8989
Mailing Address - Street 1:3300 CASHWELL DR
Mailing Address - Street 2:SUITE # 3
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-4456
Mailing Address - Country:US
Mailing Address - Phone:919-751-8989
Mailing Address - Fax:919-751-1616
Practice Address - Street 1:3300 CASHWELL DR
Practice Address - Street 2:SUITE # 3
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4456
Practice Address - Country:US
Practice Address - Phone:919-751-8989
Practice Address - Fax:919-751-1616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0015951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002810Medicaid
NC6002810Medicaid