Provider Demographics
NPI:1467075432
Name:LIVING BEYOND IT COUNSELING AND CONSULTATION SERVICES, PLLC
Entity Type:Organization
Organization Name:LIVING BEYOND IT COUNSELING AND CONSULTATION SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:WATSON
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCMHC, LCAS, CCS
Authorized Official - Phone:919-631-4831
Mailing Address - Street 1:212 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-3054
Mailing Address - Country:US
Mailing Address - Phone:919-631-4831
Mailing Address - Fax:919-400-4602
Practice Address - Street 1:201 S BRIGHTLEAF BLVD STE 6
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4077
Practice Address - Country:US
Practice Address - Phone:919-631-4831
Practice Address - Fax:919-400-4602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-25
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty