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General NPI Number Information
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NPI Number | 1144271966
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Entity Type | Individual
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Provider Name | DENISE FARANTATOS ROBERTSON LCSW/MSW, QDDP,QMHP
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Gender | Female
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 3900 BARRETT DR STE 301C
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City | RALEIGH
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State | NC
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Zip | 27609-6610
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Country | US
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Telephone | 919-520-3646
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Fax |
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Provider Business Mailing Address
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Address Line | 3304 ASHBY PL
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City | RALEIGH
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State | NC
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Zip | 27604-1602
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Country | US
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Telephone | 919-520-3646
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Fax |
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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 | C004326
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C004326
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License Number State | NC
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