Healthcare Provider Details

I. General information

NPI: 1730393729
Provider Name (Legal Business Name): SOLUTIONS COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 04/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2314 S MIAMI BLVD SUITE 154
DURHAM NC
27703-5793
US

IV. Provider business mailing address

2314 S MIAMI BLVD SUITE 154
DURHAM NC
27703-5793
US

V. Phone/Fax

Practice location:
  • Phone: 919-381-5703
  • Fax: 919-381-5701
Mailing address:
  • Phone: 919-381-5703
  • Fax: 919-381-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4985
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC006249
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2001-00146
License Number StateNC

VIII. Authorized Official

Name: MR. DELTON WADE DE VOSE
Title or Position: OWNER/EXECUTIVE CLINICAL DIRECTOR
Credential: MS, LPC
Phone: 919-381-5703