MEDICARE: MR. JAMES ROBERT ALLEN LPC

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	101YP2500X	Professional Counselor	7688	NC

General Provider Information

NPI Number	:	1851621205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES ROBERT ALLEN LPC

Provider Business Mailing Address
First Line	:	3622 SHANNON RD
Second Line	:	SUITE 104
City	:	DURHAM
State	:	NC
Zip	:	27707-3771
Country	:	US
Telephone Number	:	919-682-9195
Fax Number	:	919-827-8235

Provider Business Practice Location Address
First Line	:	3622 SHANNON RD
Second Line	:	SUITE 104
City	:	DURHAM
State	:	NC
Zip	:	27707-3771
Country	:	US
Telephone Number	:	919-682-9195
Fax Number	:	919-827-8235

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2010
Last Update Date	:	05/22/2014

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