Provider Demographics
NPI:1225549314
Name:SYMMETRY HEALTH SERVICES PLLC
Entity Type:Organization
Organization Name:SYMMETRY HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSTICK-FAIRLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCASA, CCSOTS
Authorized Official - Phone:910-361-4522
Mailing Address - Street 1:PO BOX 2425
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28353-2425
Mailing Address - Country:US
Mailing Address - Phone:910-361-4522
Mailing Address - Fax:910-361-4759
Practice Address - Street 1:501A WESTWOOD WAY
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-3459
Practice Address - Country:US
Practice Address - Phone:910-361-4522
Practice Address - Fax:910-361-4759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-17
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-22162101YA0400X
NCC0109651041C0700X
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty