| Queer Wave Counseling, Pllc | |
|
766 Moores Pond Rd Youngsville NC 27596-8199 | |
| (919) 236-3211 | |
| Not Available |
| Full Name | Queer Wave Counseling, Pllc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 766 Moores Pond Rd, Youngsville, North Carolina |
| Authorized Official Name and Position | Jeffrey Licalzi (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 9192363211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Queer Wave Counseling, Pllc 766 Moores Pond Rd Youngsville NC 27596-8199 Ph: (919) 236-3211 | Queer Wave Counseling, Pllc 766 Moores Pond Rd Youngsville NC 27596-8199 Ph: (919) 236-3211 |
| NPI Number | 1114675998 |
|---|---|
| Provider Enumeration Date | 03/11/2022 |
| Last Update Date | 03/11/2022 |
| Certification Date | 03/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114675998 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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