Provider Demographics
NPI:1790336063
Name:PADRON, NANCY CONEJO (MS, LCMHC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:CONEJO
Last Name:PADRON
Suffix:
Gender:F
Credentials:MS, LCMHC, NCC
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:CONEJO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1016 PLYMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2536
Mailing Address - Country:US
Mailing Address - Phone:863-446-0246
Mailing Address - Fax:
Practice Address - Street 1:1293 HENDERSONVILLE RD STE 19
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1956
Practice Address - Country:US
Practice Address - Phone:828-785-3580
Practice Address - Fax:828-254-0762
Is Sole Proprietor?:No
Enumeration Date:2019-09-26
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14169101YP2500X
NC14169101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional