Provider Demographics
NPI:1336376375
Name:AGAPE COUNSELING SERVICES PLLC
Entity Type:Organization
Organization Name:AGAPE COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:BRITTON
Authorized Official - Last Name:PEVERALL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:910-251-7789
Mailing Address - Street 1:217 N 5TH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-4270
Mailing Address - Country:US
Mailing Address - Phone:910-251-7789
Mailing Address - Fax:
Practice Address - Street 1:217 N 5TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-4270
Practice Address - Country:US
Practice Address - Phone:910-251-7789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)