Healthcare Provider Details

I. General information

NPI: 1558038661
Provider Name (Legal Business Name): GELISA GENAE STRINGER LCMHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GELICA GENAE JACKSON

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 SCOVILLE RD
GARNER NC
27529-7198
US

IV. Provider business mailing address

132 SCOVILLE RD
GARNER NC
27529-7198
US

V. Phone/Fax

Practice location:
  • Phone: 919-394-3419
  • Fax:
Mailing address:
  • Phone: 919-394-3419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA21255
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: