Provider Demographics
NPI:1609341627
Name:FORTITUDE COUNSELING, PLLC
Entity Type:Organization
Organization Name:FORTITUDE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZERMEMBER FORTITUDE CNS, PLLC
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:BITTERMAN
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC, LPC
Authorized Official - Phone:828-515-1495
Mailing Address - Street 1:895 STATE FARM RD STE 210
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4917
Mailing Address - Country:US
Mailing Address - Phone:828-515-1495
Mailing Address - Fax:828-515-1495
Practice Address - Street 1:895 STATE FARM RD STE 210
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4917
Practice Address - Country:US
Practice Address - Phone:828-515-1495
Practice Address - Fax:828-515-1495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health