Provider Demographics
NPI:1851808687
Name:VERENA SOCOLAR PLLC
Entity Type:Organization
Organization Name:VERENA SOCOLAR PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:VERENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOCOLAR
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:919-998-9177
Mailing Address - Street 1:150 PROVIDENCE ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-9015
Mailing Address - Country:US
Mailing Address - Phone:919-998-9177
Mailing Address - Fax:919-930-8430
Practice Address - Street 1:150 PROVIDENCE RD STE 201
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:919-998-9177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-02
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC5005679363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty