Eleanor Health Professional NC, PLLC
Organization Active NPI Psychiatry Physician · Durham, NC
NPI 1639718406 · NPPES record last updated Mar 24, 2025
Key facts
- NPI
- 1639718406
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- ELEANOR HEALTH PROFESSIONAL NC, PLLC
- Practice address
- 2402 S Miami Blvd Ste 101
Durham, NC 27703-4928 - Phone
- (919) 646-5587
- NPI assigned
- Dec 27, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- ELEANOR HEALTH PROFESSIONAL NC, PLLC
Authorized official
- Name
- Nzinga Ajabu Harrison, MD
- Title
- Founder/Owner
- Phone
- (781) 230-6838
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 1
Practitioners 14
-
Nzinga Ajabu Harrison, M.D.
-
Jalessa Shanice Cherry, LCSW
-
Regina Rae Evans, MD
-
Lilla Ford, PMHNP
-
Stephen William North, M.D.
-
Sarah Elizabeth Woodruff, FNP-C
-
Andrea Krasno, NP
-
Emily J Rayes-Prince, M.D.
-
Jamie Lee Wiles, RN, MHNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191022000310 | NC | Part B Supplier - Clinic/Group Practice | 5799017943 |
Receives reassigned benefits from 60 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hickory, NC; Durham, NC |
National Provider Directory
- Part of
- Eleanor Health Professional NC PLLC
Locations
2402 S Miami Blvd
Ste 101
Durham, NC 27703
Phone (919) 765-8730
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Addiction Medicine (Family Medicine) Physician |
207QA0401X | |||
| Addiction Medicine (Preventive Medicine) Physician |
2083A0300X | |||
| Addiction Medicine (Psychiatry & Neurology) Physician |
2084A0401X | |||
| Psychiatry Physician |
2084P0800X | Yes | ||
| Addiction Psychiatry Physician |
2084P0802X |
Addresses
Primary practice location
2402 S Miami Blvd Ste 101
Durham, NC 27703-4928
Mailing address
PO Box 386
Portsmouth, NH 03802-0386
Other providers in Durham, NC
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- Mackenzie Mallrey Eldridge
- Serena Yin on Eldridge
- Sarada Eleswarpu
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All providers in Durham, NC · Psychiatry Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.