Provider Demographics
NPI:1982868501
Name:RESOLUTIONS COUNSELING AND MEDIATION SERVICES, PLLC
Entity Type:Organization
Organization Name:RESOLUTIONS COUNSELING AND MEDIATION SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:910-358-4211
Mailing Address - Street 1:200 VALENCIA DR STE 134
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6313
Mailing Address - Country:US
Mailing Address - Phone:910-219-7800
Mailing Address - Fax:910-219-7799
Practice Address - Street 1:200 VALENCIA DR STE 134
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6313
Practice Address - Country:US
Practice Address - Phone:910-219-7800
Practice Address - Fax:910-219-7799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-13
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0045551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1235115775OtherNPI#
NC6003089Medicaid
NC1357UOtherBCBS
NC2877581OtherMEDICARE