Individual
GEORLEENA ELSIE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
8406 SIX FORKS RD STE 104, RALEIGH, NC 27615-3075
(919) 642-4857
Mailing address
PO BOX 746465, ATLANTA, GA 30374-6465
(855) 234-7483
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
17187
NC
101YM0800X
Mental Health Counselor
37PC01168200
NJ
101YM0800X
Mental Health Counselor
A17187
NC
Other
Enumeration date
01/05/2022
Last updated
08/14/2025
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