Provider Demographics
NPI:1114528403
Name:RESTORED COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:RESTORED COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VALORIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLEMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-241-9746
Mailing Address - Street 1:325 MCGILL AVE NW STE 519
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-6232
Mailing Address - Country:US
Mailing Address - Phone:704-292-6428
Mailing Address - Fax:
Practice Address - Street 1:325 MCGILL AVE NW STE 519
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-6232
Practice Address - Country:US
Practice Address - Phone:704-292-6428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty