Organization
ISA COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA L SHIELDS LLC (OWNER)
(919) 903-6167
Entity
Organization
Contact information
Practice address
1709 LEGION RD, SUITE 117, CHAPEL HILL, NC 27517-2375
(919) 903-6167
Mailing address
1709 LEGION RD, SUITE 117, CHAPEL HILL, NC 27517-2375
(919) 903-6167
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-2603
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053674960
NPI
NC
01
—
12726515
CAQH PROVIDER NUMBER
NC
Enumeration date
08/10/2016
Last updated
11/17/2016
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