Healthcare Provider Details

I. General information

NPI: 1255572830
Provider Name (Legal Business Name): NC TRAINING HELP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2009
Last Update Date: 11/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3509 HAWORTH DR SUITE 105
RALEIGH NC
27609-7238
US

IV. Provider business mailing address

3509 HAWORTH DR SUITE 105
RALEIGH NC
27609-7238
US

V. Phone/Fax

Practice location:
  • Phone: 919-896-7536
  • Fax: 919-896-7537
Mailing address:
  • Phone: 919-896-7536
  • Fax: 919-896-7537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4766
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number4766
License Number StateNC

VIII. Authorized Official

Name: MRS. ELIZABETH ANN GRADY
Title or Position: CLINICAL DIRECTOR
Credential: LPC, NCC
Phone: 919-896-7536