Provider Demographics
NPI:1265189229
Name:CASTING OUT FEARS MINISTRY NP
Entity type:Organization
Organization Name:CASTING OUT FEARS MINISTRY NP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TANISHA
Authorized Official - Middle Name:LAKIA
Authorized Official - Last Name:NEWSOME
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCAS
Authorized Official - Phone:919-519-0533
Mailing Address - Street 1:119 HERBERT ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-2205
Mailing Address - Country:US
Mailing Address - Phone:919-519-0533
Mailing Address - Fax:
Practice Address - Street 1:119 HERBERT ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-2205
Practice Address - Country:US
Practice Address - Phone:919-519-0533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty