MEDICARE: CATHOLIC CHARITIES OF THE DIOCESE OF RALEIGH, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YP2500X	Professional Counselor
2	101YS0200X	School Counselor
3	1041S0200X	School Social Worker
4	106H00000X	Marriage & Family Therapist
5	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457475238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHOLIC CHARITIES OF THE DIOCESE OF RALEIGH, INC.

Provider Business Mailing Address
First Line	:	715 NAZARETH ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27606-2187
Country	:	US
Telephone Number	:	919-828-9750
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 HIGHWOODS BLVD STE 128
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-1027
Country	:	US
Telephone Number	:	919-790-8533
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	KATHLEEN WALSH
Credential	:	ACSW
Telephone Number	:	919-821-9750

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	08/10/2009

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