Healthcare Provider Details

I. General information

NPI: 1235069980
Provider Name (Legal Business Name): SURYA COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

293 OLMSTED BLVD # 11B-8
PINEHURST NC
28374-9181
US

IV. Provider business mailing address

123 LARK DR
WEST END NC
27376-9250
US

V. Phone/Fax

Practice location:
  • Phone: 910-818-4132
  • Fax:
Mailing address:
  • Phone: 910-818-4132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY GRAY HEDGE
Title or Position: OWNER
Credential: LCSW
Phone: 910-818-4132