Provider Demographics
NPI:1417459371
Name:AWAKENINGS COUNSELING
Entity Type:Organization
Organization Name:AWAKENINGS COUNSELING
Other - Org Name:COUNSELING NEAR ME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:919-610-1676
Mailing Address - Street 1:701 TADLOCK DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-9238
Mailing Address - Country:US
Mailing Address - Phone:919-931-2463
Mailing Address - Fax:
Practice Address - Street 1:4505 FAIR MEADOWS LN STE 103
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6449
Practice Address - Country:US
Practice Address - Phone:984-204-1337
Practice Address - Fax:919-845-5431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-06
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0095221041C0700X
NC758106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty