Provider Demographics
NPI:1346902426
Name:R3 COUNSELING & COACHING SERVICES, PLLC
Entity Type:Organization
Organization Name:R3 COUNSELING & COACHING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAYONA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAYLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-350-5837
Mailing Address - Street 1:6303 HOLLY KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-2429
Mailing Address - Country:US
Mailing Address - Phone:704-350-5837
Mailing Address - Fax:
Practice Address - Street 1:325 MATTHEWS MINT HILL RD STE 210
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-0004
Practice Address - Country:US
Practice Address - Phone:704-350-5837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty