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General NPI Number Information
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NPI Number | 1598903544
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Entity Type | Individual
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Provider Name | JEREMY GARELD ENZOR LPC
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Gender | Male
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Dates
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Enumeration Date | 01/29/2009
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Last Update Date | 11/08/2018
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Provider Practice Location Address
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Address Line | 8224 GREEN LANTERN ST
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City | RALEIGH
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State | NC
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Zip | 27613-4545
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Country | US
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Telephone | 984-233-5431
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Fax |
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Provider Business Mailing Address
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Address Line | 8203 GREEN LANTERN ST APT 106
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City | RALEIGH
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State | NC
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Zip | 27613-4597
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Country | US
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Telephone | 919-561-2124
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6110
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License Number State | SC
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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 | 7284
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License Number State | NC
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