Provider Demographics
NPI:1134209992
Name:OVERTON, FRANK L (THM)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:L
Last Name:OVERTON
Suffix:
Gender:M
Credentials:THM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N CHURTON ST STE 203
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-2193
Mailing Address - Country:US
Mailing Address - Phone:919-450-7930
Mailing Address - Fax:
Practice Address - Street 1:121 N CHURTON ST STE 203
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2193
Practice Address - Country:US
Practice Address - Phone:919-450-7930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2415101YP2500X
NC164106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist