Healthcare Provider Details

I. General information

NPI: 1609063171
Provider Name (Legal Business Name): DAVID CARL VERNER PHD; CPBPPC, NC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2007
Last Update Date: 09/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 W MILLBROOK RD STE. 109
RALEIGH NC
27609-4389
US

IV. Provider business mailing address

312 W MILLBROOK RD STE. 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 TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number54
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: