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General NPI Number Information
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NPI Number | 1548734973
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Entity Type | Organization
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Legal Business Name | CONGRUENCE GROUP
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Dates
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Enumeration Date | 01/18/2019
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 605 W MAIN ST STE 101
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City | CARRBORO
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State | NC
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Zip | 27510-1693
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Country | US
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Telephone | 919-283-1274
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Fax |
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Provider Business Mailing Address
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Address Line | 605 W MAIN ST STE 101
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City | CARRBORO
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State | NC
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Zip | 27510-1693
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Country | US
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Telephone | 919-283-1274
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | LESLIE GAYLE STEVENS
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Credential | M.ED.
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Telephone | 919-283-1274
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 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 #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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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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