Healthcare Provider Details

I. General information

NPI: 1346778487
Provider Name (Legal Business Name): RONSENIA TRUELISH LINDSAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2017
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5509 CREEDMOOR RD
RALEIGH NC
27612-6312
US

IV. Provider business mailing address

5509 CREEDMOOR RD
RALEIGH NC
27612-6312
US

V. Phone/Fax

Practice location:
  • Phone: 919-573-6538
  • Fax:
Mailing address:
  • Phone: 919-573-6538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number22890
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15345
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: