Healthcare Provider Details

I. General information

NPI: 1073440624
Provider Name (Legal Business Name): AMELIA SHOLAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

203 W MILLBROOK RD STE 101
RALEIGH NC
27609-4581
US

IV. Provider business mailing address

2209 WHITE OAK RD
RALEIGH NC
27608-1453
US

V. Phone/Fax

Practice location:
  • Phone: 919-752-3666
  • Fax:
Mailing address:
  • Phone: 919-802-3790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA11803
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: