Provider Demographics
NPI:1255944864
Name:COURAGE COUNSELING, LLC
Entity type:Organization
Organization Name:COURAGE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TUESDAE
Authorized Official - Middle Name:NICHOL
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, RPT
Authorized Official - Phone:910-964-3826
Mailing Address - Street 1:260 HUGH SHELTON LOOP
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-3485
Mailing Address - Country:US
Mailing Address - Phone:910-964-3826
Mailing Address - Fax:
Practice Address - Street 1:2395 LOUPIN DR APT 71A
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-0911
Practice Address - Country:US
Practice Address - Phone:615-823-8254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty