Provider Demographics
NPI:1326283102
Name:GREYSTONE COUNSELING AND CONSULTING, INC
Entity Type:Organization
Organization Name:GREYSTONE COUNSELING AND CONSULTING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:F
Authorized Official - Last Name:BLACKBURN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-830-5749
Mailing Address - Street 1:7413 WILDERNESS RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-3637
Mailing Address - Country:US
Mailing Address - Phone:919-830-5749
Mailing Address - Fax:919-882-1277
Practice Address - Street 1:2 CONSULTANT PL
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3598
Practice Address - Country:US
Practice Address - Phone:919-830-5749
Practice Address - Fax:919-882-1277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3290101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty