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General NPI Number Information
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NPI Number | 1366268153
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Entity Type | Organization
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Legal Business Name | ILEX COUNSELING SERVICES PLLC
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 3500 WESTGATE DR STE 203
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City | DURHAM
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State | NC
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Zip | 27707-2540
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Country | US
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Telephone | 919-452-6464
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Fax |
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Provider Business Mailing Address
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Address Line | 2802 WELCOME DR
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City | DURHAM
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State | NC
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Zip | 27705-5516
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Country | US
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Telephone | 919-452-6464
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | ELIZABETH DONDERO
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Credential |
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Telephone | 919-452-6464
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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 |
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License Number State |
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