Healthcare Provider Details

I. General information

NPI: 1003510660
Provider Name (Legal Business Name): NOURISHED MINDS COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 W NC HIGHWAY 54 STE 207
DURHAM NC
27707-5597
US

IV. Provider business mailing address

1415 W NC HIGHWAY 54 STE 207
DURHAM NC
27707-5597
US

V. Phone/Fax

Practice location:
  • Phone: 919-525-1085
  • Fax:
Mailing address:
  • Phone: 919-525-1085
  • 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: REBECCA WILLIAMS
Title or Position: THERAPIST
Credential: LCMHC
Phone: 919-525-1085