Provider Demographics
NPI:1346360880
Name:S.E.L.F STRENGTHENING AND EMPOWERING THE LIVES OF OUR FUTURE,INC.
Entity Type:Organization
Organization Name:S.E.L.F STRENGTHENING AND EMPOWERING THE LIVES OF OUR FUTURE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:N
Authorized Official - Last Name:HODGE
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:619-507-3977
Mailing Address - Street 1:5401 EVERGREEN FOREST WAY
Mailing Address - Street 2:102
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-7920
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5401 EVERGREEN FOREST WAY
Practice Address - Street 2:102
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-7920
Practice Address - Country:US
Practice Address - Phone:919-325-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty