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General NPI Number Information
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NPI Number | 1720822091
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Entity Type | Individual
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Provider Name | COLLEEN FRANCES PESCI LCMHC-A
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Gender | Female
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Dates
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Enumeration Date | 06/21/2024
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 615 DOUGLAS ST STE 500
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City | DURHAM
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State | NC
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Zip | 27705-6616
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Country | US
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Telephone | 855-875-5812
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Fax |
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Provider Business Mailing Address
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Address Line | 1119 IREDELL ST APT 5
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City | DURHAM
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State | NC
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Zip | 27705-3561
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Country | US
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Telephone | 262-501-0337
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A20130
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License Number State | NC
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