Provider Demographics
NPI:1033407754
Name:TRIANGLE CENTER FOR ENRICHMENT, PLLC
Entity Type:Organization
Organization Name:TRIANGLE CENTER FOR ENRICHMENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATRENIA
Authorized Official - Middle Name:PARKS
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-294-4840
Mailing Address - Street 1:100 MEREDITH DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-5237
Mailing Address - Country:US
Mailing Address - Phone:919-294-4895
Mailing Address - Fax:
Practice Address - Street 1:100 MEREDITH DR
Practice Address - Street 2:SUITE 180
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-5237
Practice Address - Country:US
Practice Address - Phone:919-294-4895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0015281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty