Provider Demographics
NPI:1285850305
Name:AUTRY, WILLIAM FRANKLIN (LCAS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:FRANKLIN
Last Name:AUTRY
Suffix:
Gender:M
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5842 SANDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-1926
Mailing Address - Country:US
Mailing Address - Phone:919-544-9595
Mailing Address - Fax:
Practice Address - Street 1:1804 MLK JR. PARKWAY
Practice Address - Street 2:SUITE 210
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3584
Practice Address - Country:US
Practice Address - Phone:919-489-2254
Practice Address - Fax:919-403-1551
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC315101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor