Organization
COFFEE TALK THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKLYN MICHELE BLAKE LCMHC, MBA (EXECUTIVE DIRECTOR)
(919) 889-4448
Entity
Organization
Contact information
Practice address
600 NEW WAVERLY PL STE 100, CARY, NC 27518-7404
(984) 689-1714
Mailing address
600 NEW WAVERLY PL STE 100, CARY, NC 27518-7404
(984) 268-6710
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/07/2022
Last updated
08/23/2024
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