Healthcare Provider Details

I. General information

NPI: 1972015808
Provider Name (Legal Business Name): D'ELIA FAMILY SOLUTIONS COUNSELING AND COACHING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2017
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2928 THURMAN DAIRY LOOP
WAKE FOREST NC
27587-5620
US

IV. Provider business mailing address

2928 THURMAN DAIRY LOOP
WAKE FOREST NC
27587-5620
US

V. Phone/Fax

Practice location:
  • Phone: 919-825-1704
  • Fax:
Mailing address:
  • Phone: 919-825-1704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1820
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LORI D'ELIA
Title or Position: LICENSED MARRIAGE AND FAMILY THERAP
Credential: LMFT
Phone: 919-825-1704