Healthcare Provider Details

I. General information

NPI: 1023933629
Provider Name (Legal Business Name): BLACK CAT COUNSELING & WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4012 OLD STURBRIDGE DR
APEX NC
27539-9799
US

IV. Provider business mailing address

4012 OLD STURBRIDGE DR
APEX NC
27539-9799
US

V. Phone/Fax

Practice location:
  • Phone: 757-469-1720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA C EUBANKS
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LCMHC, NCC
Phone: 757-469-1720