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General NPI Number Information
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NPI Number | 1073764650
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Entity Type | Organization
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Legal Business Name | OAK CITY COUNSELING
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Dates
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Enumeration Date | 10/01/2008
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Last Update Date | 06/23/2016
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Provider Practice Location Address
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Address Line | 10830 GREATER HILLS ST
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City | RALEIGH
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State | NC
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Zip | 27614-8653
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Country | US
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Telephone | 919-271-1143
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Fax |
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Provider Business Mailing Address
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Address Line | 136 MINE LAKE CT
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City | RALEIGH
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State | NC
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Zip | 27615-6417
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Country | US
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Telephone | 919-271-1143
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Fax |
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Authorized Official
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Title or Position | OWNER/OUTPATIENT THERAPIST
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Name | MS. SARA THATCHER
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Credential | MSW LCSW
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Telephone | 919-271-1143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C005103
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License Number State | NC
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