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NPI 1114711819

NPI 1114711819 : TRUENORTH THERAPY NC, PLLC : RALEIGH, NC

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General NPI Number Information
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    NPI Number           |    1114711819
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    Entity Type          |    Organization 
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    Legal Business Name  |    TRUENORTH THERAPY NC, PLLC 
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Dates
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    Enumeration Date     |    04/07/2025
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    Last Update Date     |    04/07/2025
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Provider Practice Location Address
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    Address Line         |    1212 GUNNISON PL 
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    City                 |    RALEIGH
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    State                |    NC
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    Zip                  |    27609-5104
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    Country              |    US
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    Telephone            |    650-799-7734
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1212 GUNNISON PL 
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    City                 |    RALEIGH
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    State                |    NC
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    Zip                  |    27609-5104
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    Country              |    US
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    Telephone            |    650-799-7734
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     MARTHA  AGUE 
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    Credential           |    
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    Telephone            |    650-799-7734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0850X
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    Taxonomy Name        |    Adult Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    261QM0855X
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    Taxonomy Name        |    Adolescent and Children Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    
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    License Number State |    
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