Provider Demographics
NPI:1477211175
Name:INGRAM COUNSELING & CONSULTING, PLLC
Entity Type:Organization
Organization Name:INGRAM COUNSELING & CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TACARRA
Authorized Official - Middle Name:
Authorized Official - Last Name:INGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:919-877-6442
Mailing Address - Street 1:PO BOX 958
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-0958
Mailing Address - Country:US
Mailing Address - Phone:919-877-6442
Mailing Address - Fax:919-887-0479
Practice Address - Street 1:6034 RIVER LAKE CIR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-6000
Practice Address - Country:US
Practice Address - Phone:919-877-6442
Practice Address - Fax:919-887-0479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty