Healthcare Provider Details

I. General information

NPI: 1497130967
Provider Name (Legal Business Name): BULL CITY COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2015
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3622 LYCKAN PKWY STE 4008
DURHAM NC
27707-2539
US

IV. Provider business mailing address

3622 LYCKAN PKWY STE 4008
DURHAM NC
27707-2539
US

V. Phone/Fax

Practice location:
  • Phone: 919-213-0225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE ENGLISH
Title or Position: OWNER
Credential:
Phone: 919-213-0225