Provider Demographics
NPI:1881091767
Name:MINSK, ESTEBAN (NCC)
Entity type:Individual
Prefix:
First Name:ESTEBAN
Middle Name:
Last Name:MINSK
Suffix:
Gender:M
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 TRAWICK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-3897
Mailing Address - Country:US
Mailing Address - Phone:919-896-7536
Mailing Address - Fax:
Practice Address - Street 1:1708 TRAWICK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-3897
Practice Address - Country:US
Practice Address - Phone:919-896-7536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)