Provider Demographics
NPI:1518190560
Name:REALITY THERAPY
Entity Type:Organization
Organization Name:REALITY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WASHINGTON
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCAS
Authorized Official - Phone:910-483-1075
Mailing Address - Street 1:930 CAMBRIDGE ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-9625
Mailing Address - Country:US
Mailing Address - Phone:910-483-1075
Mailing Address - Fax:910-483-1075
Practice Address - Street 1:930 CAMBRIDGE ST
Practice Address - Street 2:SUITE 108
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-9625
Practice Address - Country:US
Practice Address - Phone:910-483-1075
Practice Address - Fax:910-483-1075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC98101YA0400X
NC3809101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty