Provider Demographics
NPI:1821789546
Name:AUDRA SOCINSKI, PSYCHOTHERAPY
Entity Type:Organization
Organization Name:AUDRA SOCINSKI, PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCMHC
Authorized Official - Prefix:
Authorized Official - First Name:AUDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOCINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-824-9448
Mailing Address - Street 1:6300 SPEAR ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:VT
Mailing Address - Zip Code:05445-8234
Mailing Address - Country:US
Mailing Address - Phone:919-824-9448
Mailing Address - Fax:
Practice Address - Street 1:6300 SPEAR ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:VT
Practice Address - Zip Code:05445-8234
Practice Address - Country:US
Practice Address - Phone:919-824-9448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)