Individual
MRS. ELLEN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
901 PAVERSTONE DR, RALEIGH, NC 27615-4710
(919) 818-4284
Mailing address
706 MONROE DR, RALEIGH, NC 27604-2357
(704) 830-7020
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8577
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P99260
—
NC
Enumeration date
09/25/2012
Last updated
03/17/2018
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