Healthcare Provider Details

I. General information

NPI: 1902992662
Provider Name (Legal Business Name): IRENE SHEINER LAZARUS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1829 EAST FRANKLIN STREET, SUITE 100D
CHAPEL HILL NC
27514
US

IV. Provider business mailing address

107 GREEN WILLOW COURT
CHAPEL HILL NC
27514-5211
US

V. Phone/Fax

Practice location:
  • Phone: 919-990-2444
  • Fax: 919-493-6921
Mailing address:
  • Phone: 919-593-2889
  • Fax: 919-493-6921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number807
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: