Healthcare Provider Details

I. General information

NPI: 1457236838
Provider Name (Legal Business Name): GIBELY ELIDAH CISNEROS-ESTRADA LMFTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 QUADRANGLE DR STE 100
CHAPEL HILL NC
27517-7890
US

IV. Provider business mailing address

6320 QUADRANGLE DR STE 100
CHAPEL HILL NC
27517-7890
US

V. Phone/Fax

Practice location:
  • Phone: 919-205-8305
  • Fax:
Mailing address:
  • Phone: 919-205-8305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number20758A
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: