Provider Demographics
NPI:1881795649
Name:GORBERG, ABBE ROXANNE (LPC,RD)
Entity type:Individual
Prefix:MS
First Name:ABBE
Middle Name:ROXANNE
Last Name:GORBERG
Suffix:
Gender:F
Credentials:LPC,RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3041 SETTLE IN LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8693
Mailing Address - Country:US
Mailing Address - Phone:919-345-4175
Mailing Address - Fax:
Practice Address - Street 1:3041 SETTLE IN LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8693
Practice Address - Country:US
Practice Address - Phone:919-345-4175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3326101YP2500X
NCL000392133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCL000392OtherNC RD LICENSURE