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Individual

MR. BRIAN P CLOUGHERTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A., M.DIV., LPC

Contact information

Practice address
4324 S ALSTON AVE STE 203, DURHAM, NC 27713-5296
(919) 806-0009
(919) 806-1201
Mailing address
112 MONTICELLO AVE, DURHAM, NC 27707-3909
(919) 672-8223
(919) 401-0987

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP1600X
Pastoral Counselor
101YP2500X
Professional Counselor
Primary
7391
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6104213
NC
Enumeration date
04/02/2009
Last updated
07/21/2022
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