Organization Active NPI

Triangle Center for Emotional Wellness,PLLC

  • Professional Counselor
  • Durham, NC
National Provider Identifier
1851689400
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2126 Issued in NC
Legal business name
TRIANGLE CENTER FOR EMOTIONAL WELLNESS,PLLC
Practice address
5011 Southpark Dr
Su. 130
Durham, NC 27713-7738
Phone
(919) 408-7839
Fax
(919) 361-1900
NPI assigned
Jul 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Shelda Abdur-Razzaq, LPC
Title
Principle
Phone
(919) 408-7839

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 2126 NC Primary

Addresses

Primary practice location

5011 Southpark Dr
Su. 130
Durham, NC 27713-7738

Mailing address

5011 Southpark Dr
Su. 130
Durham, NC 27713-7738
Phone (919) 408-7839

Other identifiers 1

IdentifierTypeStateIssuer
6102831MedicaidNC

National Provider Directory

National Provider Directory

Locations

5011 Southpark Dr
Ste 130
Durham, NC 27713
Phone (919) 405-2800

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310947200000",
    "number": "1851689400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5011 SOUTHPARK DR",
            "address_2": "SU. 130",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137738",
            "telephone_number": "919-408-7839",
            "fax_number": "919-361-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5011 SOUTHPARK DR",
            "address_2": "SU. 130",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137738",
            "telephone_number": "919-408-7839",
            "fax_number": "919-361-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIANGLE CENTER FOR EMOTIONAL WELLNESS,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-18",
        "last_updated": "2011-07-18",
        "status": "A",
        "authorized_official_last_name": "ABDUR-RAZZAQ",
        "authorized_official_first_name": "SHELDA",
        "authorized_official_title_or_position": "PRINCIPLE",
        "authorized_official_telephone_number": "919-408-7839",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "2126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102831",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.