Provider Demographics
NPI:1669566212
Name:PARRAGA, JOHN PAUL (LPC)
Entity type:Individual
Prefix:MR
First Name:JOHN PAUL
Middle Name:
Last Name:PARRAGA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W. MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510
Mailing Address - Country:US
Mailing Address - Phone:919-338-1939
Mailing Address - Fax:919-338-2729
Practice Address - Street 1:110 W. MAIN ST
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510
Practice Address - Country:US
Practice Address - Phone:919-338-1939
Practice Address - Fax:919-338-2729
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5434101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC144PGOtherBCBS
NC6103568Medicaid