Healthcare Provider Details

I. General information

NPI: 1861534794
Provider Name (Legal Business Name): FRESHWINDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 BLUE RIDGE RD SUITE 200
RALEIGH NC
27612-4650
US

IV. Provider business mailing address

4000 BLUE RIDGE RD SUITE 200
RALEIGH NC
27612-4650
US

V. Phone/Fax

Practice location:
  • Phone: 919-782-4981
  • Fax: 919-782-2474
Mailing address:
  • Phone: 919-782-4981
  • Fax: 919-782-2474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3842
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2552
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5149
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5191
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4935
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC003843
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC003327
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC005034
License Number StateNC
# 9
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC004159
License Number StateNC
# 10
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC003502
License Number StateNC
# 11
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC005179
License Number StateNC
# 12
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC002691
License Number StateNC
# 13
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number1963
License Number StateNC
# 14
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC004886
License Number StateNC

VIII. Authorized Official

Name: MS. LEOLA A YOUNG
Title or Position: OFFICE MANAGER
Credential:
Phone: 919-782-4981