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General NPI Number Information
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NPI Number | 1063760510
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Entity Type | Individual
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Provider Name | BYALINAH S-K SHAKIR-BURGESS LPC
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Gender | Female
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 3723 BENSON DR
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City | RALEIGH
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State | NC
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Zip | 27609-7324
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Country | US
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Telephone | 919-929-9610
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Fax |
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Provider Business Mailing Address
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Address Line | 1502 W NC HIGHWAY 54 STE 103
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City | DURHAM
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State | NC
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Zip | 27707-5572
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Country | US
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Telephone | 919-354-0840
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Fax | 919-748-4441
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8125
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8125
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License Number State | NC
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