Individual
JOHN WINTERS BALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 WESTERN BLVD, RALEIGH, NC 27606-2148
(919) 743-4018
Mailing address
250 S ESTES DR APT 83, CHAPEL HILL, NC 27514-7000
(828) 208-0277
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-20592
NC
103T00000X
Psychologist
5073
NC
103TA0400X
Addiction (Substance Use Disorder) Psychologist
5073
NC
103TB0200X
Cognitive & Behavioral Psychologist
5073
NC
103TC0700X
Clinical Psychologist
5073
NC
103TC1900X
Counseling Psychologist
5073
NC
103TE1100X
Exercise & Sports Psychologist
5073
NC
103TF0200X
Forensic Psychologist
Primary
5073
NC
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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