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Behavioral Health & Social Service Providers Counselor Mental Health

Provider NPI: 1235311424

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
Tel: 919-222-4359  Fax: --

Business Mailing Address:
Tel: 919-222-4359  Fax: 919-778-1909

NPI Information:
NPI: 1235311424
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
N101YM0800XBehavioral Health & Social Service Providers
Mental Health
N103TA0400XBehavioral Health & Social Service Providers
N103TA0700XBehavioral Health & Social Service Providers
N103TB0200XBehavioral Health & Social Service Providers
N103TC2200XBehavioral Health & Social Service Providers
N103TM1800XBehavioral Health & Social Service Providers
N104100000XBehavioral Health & Social Service Providers
Social Worker
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 171M00000X





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