Provider Demographics
NPI:1235294588
Name:FURAN, JEANETTE MOORE (LPC)
Entity Type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:MOORE
Last Name:FURAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 SILVERS WELCH RD
Mailing Address - Street 2:
Mailing Address - City:OLD FORT
Mailing Address - State:NC
Mailing Address - Zip Code:28762-8755
Mailing Address - Country:US
Mailing Address - Phone:828-668-4018
Mailing Address - Fax:828-668-4018
Practice Address - Street 1:852 SILVERS WELCH RD
Practice Address - Street 2:
Practice Address - City:OLD FORT
Practice Address - State:NC
Practice Address - Zip Code:28762-8755
Practice Address - Country:US
Practice Address - Phone:828-668-4018
Practice Address - Fax:828-668-4018
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3479101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103056Medicaid