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General NPI Number Information
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NPI Number | 1427923291
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Entity Type | Individual
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Provider Name | DUBORIS JAMES PETERKIN
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Gender | Male
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 3824 BARRETT DR STE 105
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City | RALEIGH
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State | NC
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Zip | 27609-7220
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Country | US
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Telephone | 919-790-7775
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Fax | 919-790-9755
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Provider Business Mailing Address
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Address Line | 224 CROSSFIRE RD
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-8560
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Country | US
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Telephone | 919-790-7775
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Fax | 919-790-8664
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-26285
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License Number State | NC
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