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General NPI Number Information
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NPI Number | 1285577684
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Entity Type | Organization
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Legal Business Name | SPOKE BEHAVIORAL HEALTH, PLLC
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Dates
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Enumeration Date | 04/10/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | 1200 BROAD ST STE 101
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City | DURHAM
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State | NC
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Zip | 27705-3576
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Country | US
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Telephone | 984-317-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 BROAD ST STE 101
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City | DURHAM
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State | NC
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Zip | 27705-3576
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | IAN J PALOMBO
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Credential | EDD, LCMHC
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Telephone | 720-984-1306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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