MEDICARE: ASCENCIA HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician

General Provider Information

NPI Number	:	1710837802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASCENCIA HEALTH

Provider Business Mailing Address
First Line	:	501 W WILLIAMS ST UNIT 1036
Second Line	:
City	:	APEX
State	:	NC
Zip	:	27502-2297
Country	:	US
Telephone Number	:	984-319-7357
Fax Number	:	919-935-0858

Provider Business Practice Location Address
First Line	:	801 CASCADE POINTE LN STE 102
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-5824
Country	:	US
Telephone Number	:	919-341-7573
Fax Number	:	919-935-0858

Authorized Official
Title or Position	:	CEO
Name	:	MS. SHIRLEYJO B LEE
Credential	:
Telephone Number	:	984-319-7357

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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Directions to “ASCENCIA HEALTH ” Practice Location

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