Provider Demographics
NPI:1235413337
Name:EATON, FRANK (MA NCC,LPC)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:EATON
Suffix:
Gender:M
Credentials:MA NCC,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13128 SARGAS ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-6933
Mailing Address - Country:US
Mailing Address - Phone:919-749-0540
Mailing Address - Fax:
Practice Address - Street 1:13128 SARGAS ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-6933
Practice Address - Country:US
Practice Address - Phone:919-749-0540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10153101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1235413337Medicaid