Provider Demographics
NPI:1780967240
Name:CAREER FULFILLMENT SERVICES, PLLC
Entity type:Organization
Organization Name:CAREER FULFILLMENT SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YUKO
Authorized Official - Middle Name:
Authorized Official - Last Name:KISHIMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:252-412-7022
Mailing Address - Street 1:401 W 1ST ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-1905
Mailing Address - Country:US
Mailing Address - Phone:252-412-7022
Mailing Address - Fax:252-544-5245
Practice Address - Street 1:401 W 1ST ST
Practice Address - Street 2:SUITE G
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-1905
Practice Address - Country:US
Practice Address - Phone:252-412-7022
Practice Address - Fax:252-544-5245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4030103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty