Provider Demographics
NPI:1972289668
Name:PEACEFUL WISDOM COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:PEACEFUL WISDOM COUNSELING SERVICES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-525-1467
Mailing Address - Street 1:1220 TIMBER DR E # 1021
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-6917
Mailing Address - Country:US
Mailing Address - Phone:919-525-1461
Mailing Address - Fax:
Practice Address - Street 1:123 PRONGHORN DEER CT
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7186
Practice Address - Country:US
Practice Address - Phone:252-432-0948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty