Provider Demographics
NPI:1851990212
Name:CHRISTIAN COUNSELING ASSOCIATES OF RALEIGH, PLLC
Entity Type:Organization
Organization Name:CHRISTIAN COUNSELING ASSOCIATES OF RALEIGH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:919-260-5830
Mailing Address - Street 1:7008 HARPS MILL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3242
Mailing Address - Country:US
Mailing Address - Phone:919-260-5830
Mailing Address - Fax:
Practice Address - Street 1:7008 HARPS MILL RD STE 103
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3242
Practice Address - Country:US
Practice Address - Phone:919-260-5830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-17
Last Update Date:2020-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty