Provider Demographics
NPI:1952994170
Name:NOURISH CAROLINA COUNSELING
Entity Type:Organization
Organization Name:NOURISH CAROLINA COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTTANCE
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:919-752-3666
Mailing Address - Street 1:9204 FALLS OF NEUSE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2479
Mailing Address - Country:US
Mailing Address - Phone:919-752-3666
Mailing Address - Fax:919-289-1757
Practice Address - Street 1:9204 FALLS OF NEUSE RD STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2479
Practice Address - Country:US
Practice Address - Phone:919-752-3666
Practice Address - Fax:919-289-1757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty