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General NPI Number Information
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NPI Number | 1396283669
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Entity Type | Individual
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Provider Name | DESTINY NICOLE BAUER LCMHC
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Gender | Female
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 1500 E ASH ST
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City | GOLDSBORO
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State | NC
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Zip | 27530-5204
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Country | US
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Telephone | 919-617-7478
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Fax | 919-438-0343
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Provider Business Mailing Address
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Address Line | 222 N MARION DR
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City | GOLDSBORO
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State | NC
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Zip | 27534-7613
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Country | US
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Telephone | 919-763-5258
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Fax | 919-438-0343
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 12778
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License Number State | NC
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