Healthcare Provider Details

I. General information

NPI: 1467389528
Provider Name (Legal Business Name): JEANIE SELENE BYRNE MS, LCMHC-A, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SELENE BYRNE MS, LCMCH-A, NCC

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1037 HAVEN HOLLOW WAY
DURHAM NC
27713-6051
US

IV. Provider business mailing address

1037 HAVEN HOLLOW WAY
DURHAM NC
27713-6051
US

V. Phone/Fax

Practice location:
  • Phone: 808-464-7568
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA22867
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: