Provider Demographics
NPI:1831508985
Name:MARKOWSKI, EDWARD TYREE (LPC)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:TYREE
Last Name:MARKOWSKI
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 1:2717 ASHLAND ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608-1225
Mailing Address - Country:US
Mailing Address - Phone:443-848-8782
Mailing Address - Fax:800-798-2171
Practice Address - Street 1:380 RALEIGH ST
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9047
Practice Address - Country:US
Practice Address - Phone:443-848-8782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-02
Last Update Date:2014-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10666101YP2500X
MDLC2550101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional