Healthcare Provider Details

I. General information

NPI: 1356265755
Provider Name (Legal Business Name): RED PINE COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

3317 HORTON ST
RALEIGH NC
27607-3413
US

IV. Provider business mailing address

3317 HORTON ST
RALEIGH NC
27607-3413
US

V. Phone/Fax

Practice location:
  • Phone: 252-943-1536
  • Fax:
Mailing address:
  • Phone: 252-943-1536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: EDMUND TAYLOE BUCKMAN IV
Title or Position: OWNER
Credential: LCMHCS
Phone: 252-943-1536