MEDICARE: SYNERGY4 YOUTH NC PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1174497382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNERGY4 YOUTH NC PLLC

Provider Business Mailing Address
First Line	:	1312 HOSMER CT
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587
Country	:	US
Telephone Number	:	919-358-2339
Fax Number	:

Provider Business Practice Location Address
First Line	:	1312 HOSMER CT
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-9433
Country	:	US
Telephone Number	:	919-358-2339
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERPIST
Name	:	SHUREKA GUINOO
Credential	:	MSW LCSW TFCBT
Telephone Number	:	919-358-2339

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	10/01/2025

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