Healthcare Provider Details

I. General information

NPI: 1982903407
Provider Name (Legal Business Name): AMY ELIZABETH DUFFY PHD LCMHCS NCC CCTP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 S EAST ST
RALEIGH NC
27601-2369
US

IV. Provider business mailing address

2681 NOBLEWOOD CIR APT 2238
RALEIGH NC
27604-1869
US

V. Phone/Fax

Practice location:
  • Phone: 919-791-7545
  • Fax: 919-747-4257
Mailing address:
  • Phone: 919-791-7545
  • Fax: 919-747-4257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7903
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: