Provider Demographics
NPI:1629310198
Name:ALTIERI, BARBARA AGNES (CSAC)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:AGNES
Last Name:ALTIERI
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:MISS
Other - First Name:BARBARA
Other - Middle Name:AGNES
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSAC
Mailing Address - Street 1:225 HICKORY GLEN LN
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-8633
Mailing Address - Country:US
Mailing Address - Phone:919-567-0445
Mailing Address - Fax:919-747-0634
Practice Address - Street 1:111 SUNNYBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1827
Practice Address - Country:US
Practice Address - Phone:919-747-0622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2628101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)