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Organization
WAKE RENEWAL COUNSELING, PLLC
Active
Organization
WAKE RENEWAL COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KEISHA HINTON BRYAN LCSW, LCAS (OWNTER/THERAPIST)
(919) 520-9392
Entity
Organization
Contact information
Practice address
1008 BIG OAK CT STE F, KNIGHTDALE, NC 27545-6566
(919) 520-9392
(919) 261-1675
Mailing address
1008 BIG OAK CT STE F, KNIGHTDALE, NC 27545-6566
(919) 520-9392
(919) 261-1675
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C006619
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6112015
—
NC
Enumeration date
07/01/2013
Last updated
07/01/2013
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