Basic Information
Provider Information
NPI: 1922371954
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NESMITH
FirstName: CARA
MiddleName: BENNETT
NamePrefix: MS.
NameSuffix:  
Credential: LQP, MSW, LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: NESMITH
OtherFirstName: CARA
OtherMiddleName: BENNETT
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: LQP, MSW, LCSW
OtherLastNameType: 2
Mailing Information
Address1: 2670 DURHAM CHAPEL HILL BLVD
Address2:  
City: DURHAM
State: NC
PostalCode: 277072829
CountryCode: US
TelephoneNumber: 9192519001
FaxNumber: 9192519008
Practice Location
Address1: 2670 DURHAM CHAPEL HILL BLVD
Address2:  
City: DURHAM
State: NC
PostalCode: 277072829
CountryCode: US
TelephoneNumber: 9192519001
FaxNumber: 9192519008
Other Information
ProviderEnumerationDate: 02/22/2012
LastUpdateDate: 06/11/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XC008051NCY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


Home