Provider Demographics
NPI:1457514275
Name:IKECHUKWU, FLORENCE OLUCHI (PHD LCAS LCSW CS)
Entity Type:Individual
Prefix:DR
First Name:FLORENCE
Middle Name:OLUCHI
Last Name:IKECHUKWU
Suffix:
Gender:F
Credentials:PHD LCAS LCSW CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 N GREGSON ST STE 3D
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1164
Mailing Address - Country:US
Mailing Address - Phone:919-697-1385
Mailing Address - Fax:
Practice Address - Street 1:1530 N GREGSON ST STE 3D
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-1164
Practice Address - Country:US
Practice Address - Phone:919-697-1385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X
NC1292101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)