| Southern Wake Counseling Center | |
|
320 N Judd Pkwy Ne Suite 200 Fuquay Varina NC 27526-2624 | |
| (919) 557-8222 | |
| Not Available |
| Full Name | Southern Wake Counseling Center |
|---|---|
| Speciality | Counselor |
| Location | 320 N Judd Pkwy Ne, Fuquay Varina, North Carolina |
| Authorized Official Name and Position | Claudine Bernice Parker (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9195578222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Wake Counseling Center 320 N Judd Pkwy Ne Suite 200 Fuquay Varina NC 27526-2624 Ph: (919) 557-8222 | Southern Wake Counseling Center 320 N Judd Pkwy Ne Suite 200 Fuquay Varina NC 27526-2624 Ph: (919) 557-8222 |
| NPI Number | 1356596720 |
|---|---|
| Provider Enumeration Date | 11/26/2008 |
| Last Update Date | 11/26/2008 |
| Medicare PECOS PAC ID | 9830535806 |
|---|---|
| Medicare Enrollment ID | O20240313000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356596720 | NPI | - | NPPES |
| 6103792 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 6827 (North Carolina) | Primary |
| Provider Name | Claudine Bernice Langdon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306020870 PECOS PAC ID: 1658717624 Enrollment ID: I20240313000069 |
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