Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | NC | |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | NC | |
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 3259-A | NC |
NPI | 1003156159 |
---|---|
Provider Name | Ms. Sheila Renee Mcrae |
First Address | Weldon, NC 27890-0883 |
Second Address | Roanoke Rapids, NC 27870-2656 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2013 |
Last Update Date | 09/03/2014 |