Healthcare Provider Details

I. General information

NPI: 1952625097
Provider Name (Legal Business Name): LEE ESTHER OPATA MS, NBCLPC BRD ELIG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 03/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303B S MAIN ST
LAURINBURG NC
28352-3833
US

IV. Provider business mailing address

303 B SOUTH MAIN STREET
LAURINBURG NC
28352
US

V. Phone/Fax

Practice location:
  • Phone: 910-610-4494
  • Fax: 910-610-4161
Mailing address:
  • Phone: 910-610-4494
  • Fax: 910-610-4161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: