Basic Information
| Provider Information | |||||||||
| NPI: | 1700180965 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOWE | ||||||||
| FirstName: | TENEISHA | ||||||||
| MiddleName: | MICHELLE | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4905 ALENJA LN | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276165025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192645035 | ||||||||
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| Practice Location | |||||||||
| Address1: | 204 N PERSON ST | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276011047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198342000 | ||||||||
| FaxNumber: | 9198342001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2011 | ||||||||
| LastUpdateDate: | 01/03/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 8372 | NC | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | 8372 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.