Healthcare Provider Details

I. General information

NPI: 1720568348
Provider Name (Legal Business Name): URBAN HEALING COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 08/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8392 SIX FORKS RD STE 201
RALEIGH NC
27615-3061
US

IV. Provider business mailing address

8392 SIX FORKS RD STE 201
RALEIGH NC
27615-3061
US

V. Phone/Fax

Practice location:
  • Phone: 919-322-9529
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JANAYA SADLER
Title or Position: LCSW
Credential:
Phone: 919-322-9529