Provider Demographics
NPI:1922648633
Name:SANTANA THERAPY & COUNSELING, PLLC
Entity Type:Organization
Organization Name:SANTANA THERAPY & COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:ARTEMIS
Authorized Official - Last Name:KNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-298-0166
Mailing Address - Street 1:1788 HERITAGE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-3948
Mailing Address - Country:US
Mailing Address - Phone:919-399-9114
Mailing Address - Fax:
Practice Address - Street 1:1788 HERITAGE CENTER DR
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-3948
Practice Address - Country:US
Practice Address - Phone:919-399-9114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty