Provider Demographics
NPI:1225631963
Name:RIVERS OF PEACE COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:RIVERS OF PEACE COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/ CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, LCAS-A
Authorized Official - Phone:910-689-6558
Mailing Address - Street 1:PO BOX 27070
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-5034
Mailing Address - Country:US
Mailing Address - Phone:910-689-6558
Mailing Address - Fax:910-491-8552
Practice Address - Street 1:3321 BURBERRY DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-6208
Practice Address - Country:US
Practice Address - Phone:910-689-6558
Practice Address - Fax:910-491-8552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)