Healthcare Provider Details

I. General information

NPI: 1063344711
Provider Name (Legal Business Name): CEDARPATH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 BROAD ST STE 101
DURHAM NC
27705-3576
US

IV. Provider business mailing address

1200 BROAD ST STE 101
DURHAM NC
27705-3576
US

V. Phone/Fax

Practice location:
  • Phone: 984-317-3111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. IAN J PALOMBO
Title or Position: PRESIDENT
Credential: EDD, MA, LPC, LCMHC
Phone: 984-317-3111