Healthcare Provider Details

I. General information

NPI: 1851681662
Provider Name (Legal Business Name): SHIGLEY COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2011
Last Update Date: 04/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3717 NATIONAL DR STE 220
RALEIGH NC
27612-4067
US

IV. Provider business mailing address

3717 NATIONAL DR STE 220
RALEIGH NC
27612-4067
US

V. Phone/Fax

Practice location:
  • Phone: 919-909-2288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number613
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC006159
License Number StateNC

VIII. Authorized Official

Name: DR. HAL SHIGLEY
Title or Position: OWNER
Credential:
Phone: 919-909-2288