Healthcare Provider Details

I. General information

NPI: 1003604703
Provider Name (Legal Business Name): ASCEND PATH ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 W HARGETT ST STE 301
RALEIGH NC
27601-1351
US

IV. Provider business mailing address

127 W HARGETT ST STE 301
RALEIGH NC
27601-1351
US

V. Phone/Fax

Practice location:
  • Phone: 336-613-3795
  • Fax:
Mailing address:
  • Phone: 336-613-3795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT A A CARRIER II
Title or Position: COO
Credential:
Phone: 315-212-4807