1013349356 NPI number — WAKE COUNSELING AND MEDIATION, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013349356 NPI number — WAKE COUNSELING AND MEDIATION, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WAKE COUNSELING AND MEDIATION, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MANPREET LEHAL, NCC, LPC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013349356
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/08/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
113 HIGHLAND MIST CIRCLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APEX
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27539-9998
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-285-1818
Provider Business Mailing Address Fax Number:
888-809-3910

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
112 N. SALEM STREET
Provider Second Line Business Practice Location Address:
SUITE #201-I
Provider Business Practice Location Address City Name:
APEX
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27502-9998
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-285-1818
Provider Business Practice Location Address Fax Number:
888-809-3910
Provider Enumeration Date:
08/08/2013

Additional Information

Authorized Official

Authorized Official Last Name:
LEHAL
Authorized Official First Name:
MANPREET
Authorized Official Middle Name:
KAUR
Authorized Official Title or Position:
OWNER / CLINICIAN
Authorized Official Telephone Number:
919-285-1818

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  7425 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6104216 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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