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General NPI Number Information
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NPI Number | 1912660069
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Entity Type | Organization
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Legal Business Name | PARKER RUBEN COUNSELING CENTER
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Dates
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Enumeration Date | 10/15/2021
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 5041 VALLEY STREAM DR
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City | RALEIGH
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State | NC
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Zip | 27616-0761
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Country | US
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Telephone | 919-451-0831
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Fax | 919-977-0596
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Provider Business Mailing Address
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Address Line | PO BOX 58161
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City | RALEIGH
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State | NC
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Zip | 27658-8161
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Country | US
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Telephone | 919-451-0831
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Fax | 919-977-0596
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Authorized Official
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Title or Position | CLINICAL MENTAL HEALTH COUNSELOR
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Name | MRS. CAROL LYNN BATTLE-FERGUSON
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Credential | LCMHCA
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Telephone | 919-451-0831
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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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