Provider Demographics
NPI:1831582618
Name:KEYS TO RECOVERY COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:KEYS TO RECOVERY COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:SPENCER
Authorized Official - Last Name:VANN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCAS
Authorized Official - Phone:919-435-8164
Mailing Address - Street 1:308 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-2640
Mailing Address - Country:US
Mailing Address - Phone:919-435-8164
Mailing Address - Fax:
Practice Address - Street 1:1784 HERITAGE CENTER DR
Practice Address - Street 2:SUITE 204
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-3989
Practice Address - Country:US
Practice Address - Phone:919-435-8164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty