MEDICARE: PEACE COUNSELING OF RALEIGH, 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1790639607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE COUNSELING OF RALEIGH, PLLC

Provider Business Mailing Address
First Line	:	702 E HARGETT ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27601-1522
Country	:	US
Telephone Number	:	919-358-6505
Fax Number	:

Provider Business Practice Location Address
First Line	:	824 N BLOODWORTH ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-1232
Country	:	US
Telephone Number	:	919-358-6505
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LINDSAY JORDAN
Credential	:	LCSW
Telephone Number	:	919-358-6505

Provider Enumeration Date	:	02/26/2026
Last Update Date	:	02/26/2026

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