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General NPI Number Information
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NPI Number | 1790303915
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Entity Type | Organization
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Legal Business Name | SAFE PLACE COUNSELING
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 20 W COLONY PL STE 280
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City | DURHAM
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State | NC
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Zip | 27705-5591
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Country | US
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Telephone | 800-540-7173
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Fax |
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Provider Business Mailing Address
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Address Line | 20 W COLONY PL STE 280
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City | DURHAM
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State | NC
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Zip | 27705-5591
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Country | US
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Telephone | 800-540-7173
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MALIK MUHAMMAD
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Credential |
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Telephone | 800-540-7173
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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