Healthcare Provider Details

I. General information

NPI: 1932815966
Provider Name (Legal Business Name): CHENQIAN LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2023
Last Update Date: 01/24/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 FAYETTEVILLE ST STE 1410
RALEIGH NC
27601-2950
US

IV. Provider business mailing address

8516 OVATION DR
CARY NC
27513-2647
US

V. Phone/Fax

Practice location:
  • Phone: 919-886-4052
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: