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Individual

MS. KEISHA J BLOUNT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA,LCAS,CCS

Contact information

Practice address
5312 SIX FORKS RD STE 301, RALEIGH, NC 27609-4458
(984) 444-4741
Mailing address
8 MOONSTONE CT, DURHAM, NC 27703-2682
(919) 451-0072

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1095
NC
251S00000X
Community/Behavioral Health Agency
1095
NC

Other

Enumeration date
06/17/2008
Last updated
11/13/2024
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