Healthcare Provider Details

I. General information

NPI: 1104656420
Provider Name (Legal Business Name): WHOLEHEARTEDLY DARING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2024
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 PINNER WEALD WAY STE 101
CARY NC
27513-2607
US

IV. Provider business mailing address

800 PINNER WEALD WAY STE 101
CARY NC
27513-2607
US

V. Phone/Fax

Practice location:
  • Phone: 919-656-8722
  • Fax:
Mailing address:
  • Phone: 919-656-8722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HEIDI STERN BUNCE
Title or Position: OWNER
Credential: LCSW
Phone: 919-656-8722