Healthcare Provider Details

I. General information

NPI: 1558297416
Provider Name (Legal Business Name): JESSLYN MARIAH DURLING PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 LAKE BOONE TRL STE 200
RALEIGH NC
27607-7507
US

IV. Provider business mailing address

108 W FIRE TOWER RD
WINTERVILLE NC
28590-8371
US

V. Phone/Fax

Practice location:
  • Phone: 919-445-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number103720
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: