# SOUTHEAST FAMILY SERVICES OF RALEIGH

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1902199748
- **Authorized official:** BRENDA VATH (OFFICE MANAGER)
- **Authorized official phone:** (919) 783-8846

## Contact information

- **Practice address:** 3716 NATIONAL DR, SUITE 124, RALEIGH, NC 27612-4068
- **Practice address phone:** (919) 783-8846
- **Practice address fax:** (919) 783-7305
- **Mailing address:** 3716 NATIONAL DR, SUITE 124, RALEIGH, NC 27612-4068
- **Mailing address phone:** (919) 783-8846
- **Mailing address fax:** (919) 783-7305

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 3757 | NC | Yes |
| 225XP0200X | Pediatric Occupational Therapist | 5028 | NC | — |
| 235Z00000X | Speech-Language Pathologist | 6834 | NC | — |

## Other

- **Enumeration date:** 05/26/2011
- **Last updated:** 05/26/2011