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General NPI Number Information
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NPI Number | 1861626434
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Entity Type | Organization
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Legal Business Name | NORTH WAKE COUNSELING PARTNERS
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 211 E. SIX FORKS RD SUITE 105
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City | RALEIGH
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State | NC
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Zip | 27609-7745
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Country | US
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Telephone | 919-836-1597
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Fax | 919-836-1598
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Provider Business Mailing Address
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Address Line | 211 E. SIX FORKS RD SUITE 105
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City | RALEIGH
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State | NC
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Zip | 27609-7745
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Country | US
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Telephone | 919-836-1597
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Fax | 919-836-1598
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Authorized Official
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Title or Position | PART OWNER
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Name | MR. DANIEL AYERS
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Credential | LCSW
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Telephone | 919-368-3172
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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 | C004952
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License Number State | NC
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