Healthcare Provider Details

I. General information

NPI: 1073683702
Provider Name (Legal Business Name): TRIANGLE PASTORAL COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 W MILLBROOK RD SUITE 109
RALEIGH NC
27609-4389
US

IV. Provider business mailing address

312 W MILLBROOK RD SUITE 109
RALEIGH NC
27609-4389
US

V. Phone/Fax

Practice location:
  • Phone: 919-845-9977
  • Fax: 919-845-9761
Mailing address:
  • Phone: 919-845-9977
  • Fax: 919-845-9761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateNC

VIII. Authorized Official

Name: ALANA FRAZIER
Title or Position: DIRECTOR
Credential: LCSW
Phone: 919-845-9977