Basic Information
| Provider Information | |||||||||
| NPI: | 1477839967 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HANCOCK-RIOS | ||||||||
| FirstName: | FLORCITA | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LPC LCAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2003 GODWIN AVE STE A | ||||||||
| Address2: | |||||||||
| City: | LUMBERTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283583150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9107398849 | ||||||||
| FaxNumber: | 9107398698 | ||||||||
| Practice Location | |||||||||
| Address1: | 803 STAMPER RD STE G | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283034193 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102237114 | ||||||||
| FaxNumber: | 9105503803 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2011 | ||||||||
| LastUpdateDate: | 06/17/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 21977 | NC | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YP2500X | 8686 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 062074 | 05 | NC | MEDICAID |