Provider Demographics
NPI:1639401268
Name:RHEMA COUNSELING & SUPPORT SERVICES, PC
Entity Type:Organization
Organization Name:RHEMA COUNSELING & SUPPORT SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,LCAS, NCC
Authorized Official - Phone:919-544-1300
Mailing Address - Street 1:5317 HIGHGATE DR
Mailing Address - Street 2:SUITE 214
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6622
Mailing Address - Country:US
Mailing Address - Phone:919-544-1300
Mailing Address - Fax:919-544-1331
Practice Address - Street 1:5317 HIGHGATE DR
Practice Address - Street 2:SUITE 214
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6622
Practice Address - Country:US
Practice Address - Phone:919-544-1300
Practice Address - Fax:919-544-1331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1884101YA0400X
NC7306101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6006982Medicaid