Provider Demographics
NPI:1790796951
Name:HORTON, LOUISE J (MSW,LCSW, BCD)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:J
Last Name:HORTON
Suffix:
Gender:F
Credentials:MSW,LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 TOPSFIELD CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2330
Mailing Address - Country:US
Mailing Address - Phone:919-819-9449
Mailing Address - Fax:
Practice Address - Street 1:107 WINDEL DR
Practice Address - Street 2:SUITE 213
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4469
Practice Address - Country:US
Practice Address - Phone:919-819-9449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCOO39701041C0700X, 101Y00000X, 104100000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2315540OtherCIGNA
NC777167000OtherMEDCOST
NC542919OtherVALUEOPTIONS
NC6003292Medicaid
NC1429JOtherBCBS
NC777167000OtherMAGELLAN
NC7860862OtherAETNA
NC7860862OtherAETNA