# ENVISION SOLUTIONS THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134077076
- **Authorized official:** SAMANTHA LORAINE BLANCO LCSW (LICENSED CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (910) 580-0594

## Contact information

- **Practice address:** 4492 MIDDLETOWN DR, WAKE FOREST, NC 27587-4187
- **Practice address phone:** (910) 580-0594
- **Mailing address:** PO BOX 549, WAKE FOREST, NC 27588-0549
- **Mailing address phone:** (910) 580-0594

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 03/17/2026
- **Last updated:** 03/17/2026