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Organization

FONSECA'S FAMILY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GERNISHA A FONSECA (CEO)
(919) 683-1500
Entity
Organization

Contact information

Practice address
1111 FAYETTEVILLE ST, DURHAM, NC 27701-3918
(919) 683-1500
(919) 683-1004
Mailing address
1111 FAYETTEVILLE ST, DURHAM, NC 27701-3918
(919) 683-1500
(919) 683-1004

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
10/22/2007
Last updated
01/04/2008
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