Provider Demographics
NPI:1336533116
Name:AVALON COUNSELING SERVICES PA
Entity type:Organization
Organization Name:AVALON COUNSELING SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCS
Authorized Official - Phone:910-323-0965
Mailing Address - Street 1:PO BOX 87041
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-7041
Mailing Address - Country:US
Mailing Address - Phone:910-323-0965
Mailing Address - Fax:910-323-0310
Practice Address - Street 1:916 B ARSENAL AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305
Practice Address - Country:US
Practice Address - Phone:910-323-0965
Practice Address - Fax:910-323-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5091101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty