Individual
MR. HUGH JEROME WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED., LPC
Contact information
Practice address
4611 WESTERN BLVD, RALEIGH, NC 27606-1815
(919) 601-0540
(919) 557-9661
Mailing address
208 WEATHERVANE WAY, HOLLY SPRINGS, NC 27540-8508
(919) 601-0540
(919) 557-9661
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2458
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128C1
BCBS PROVIDER #
NC
Enumeration date
05/05/2006
Last updated
07/08/2007
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