Healthcare Provider Details

I. General information

NPI: 1386584274
Provider Name (Legal Business Name): PANKA CASSAR LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PANKA PAVLOVA

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W WILLIAMS ST STE 280
APEX NC
27502-5203
US

IV. Provider business mailing address

1809 HADDINGTON DR
DURHAM NC
27712-8976
US

V. Phone/Fax

Practice location:
  • Phone: 919-800-8114
  • 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:
Title or Position:
Credential:
Phone: