VICTORIA LEIGH FAHNESTOCK (NPI# 1134747702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134747702 |
| Entity Type | Individual |
| Full Name | VICTORIA LEIGH FAHNESTOCK |
| Credential | LCSWA |
| Practice Address |
3604 Shannon Rd Ste 200 Durham NC 27707-6343 |
| Mailing Address |
5543 Spindlewood Ct Durham NC 27703-8535 |
| Practice Telephone | 9194032122 |
| Mailing Telephone | 2524521023 |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-07-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
P014882 | NC | Behavioral Health & Social Service Providers |
| Street Address |
3604 SHANNON RD STE 200 |
| City | DURHAM |
| State | NC |
| Zip Code | 27707-6343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093898603 | Jeffrey Miller | Social Worker | 3604 Shannon Rd Ste 200, Durham, NC 27707 | 2006-10-24 |
| 1831654649 | James Henry Feldman | Psychiatry & Neurology | 3604 Shannon Rd Ste 200, Durham, NC 27707-6343 | 2019-02-06 |
| 1639643836 | Alexandra Koch | Physician Assistant | 3604 Shannon Rd Ste 200, Durham, NC 27707-6343 | 2019-01-22 |
| 1548745672 | Nicole Lloyd Johnson | Physician Assistant | 3604 Shannon Rd Ste 200, Durham, NC 27707-6343 | 2018-09-25 |
| 1780056820 | Patricia Mckissic | Nurse Practitioner | 3604 Shannon Rd Ste 200, Durham, NC 27707-6343 | 2015-10-28 |
| 1851424717 | Llewlee Livermore Sawyer | Psychologist | 3604 Shannon Rd Ste 200, Durham, NC 27707 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538785928 | Ceara Smith | Social Worker | 1415 W Nc 54 Buidling 200, Suite 111, Durham, NC 27707 | 2020-06-22 |
| 1114554094 | Lauren Michelle Grosse | Physician Assistant | Fastmed Urgent Care 7010 Nc-751, Durham, NC 27707 | 2020-03-23 |
| 1386289635 | Ashley Bailey | Counselor | 1801 Fayetteville Street, Durham, NC 27707 | 2019-11-11 |
| 1881249886 | Erin Ramona Leger | Physical Therapist | 3706 Mayfair St, Ste 120, Durham, NC 27707 | 2019-08-06 |
| 1417417262 | Carmen Elisabeth Sanchez | Psychologist | 3326 Durham Chapel Hill Blvd Bldg D, Durham, NC 27707 | 2019-03-20 |
| 1477026144 | Pope Behavioral Health and Wellness | Counselor | 5102 Chapel Hill Durham Blvd., Suite 101, Durham, NC 27707 | 2019-01-06 |
| 1043780778 | Jessica Ann Revels | Counselor | 1415 West North Carolina 54, Building 100 Suite # 204, Durham, NC 27707 | 2018-11-26 |
| 1558830125 | Michael Brown | Counselor | 1502 W Nc-54, Suite 505, Durham, NC 27707 | 2018-11-13 |
| 1780152827 | Cassandra Gerwig Shaw | Registered Nurse | 5324 Mcfarland Dr Ste 310, Durham, NC 27707 | 2018-11-07 |
| 1942776232 | Lisa J Keskitalo | Physical Therapist | 3708 Mayfair St Ste 120, Durham, NC 27707 | 2018-10-15 |
| Find all providers in zip 27707 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971315 | Danielle Cullen | Counselor | 839 Onslow St, Durham, NC 27705-4244 | 2020-10-30 |
| 1255930269 | Meredith M Dangel | Counselor | 5015 Southpark Dr Ste 240, Durham, NC 27713-7736 | 2020-10-21 |
| 1699380899 | Angela Teal | Counselor | 314 Hardwick Dr, Durham, NC 27713-7602 | 2020-09-14 |
| 1245841386 | Elana Baumann-carbrey | Counselor | 606 W Markham Ave # Rs, Durham, NC 27701-1618 | 2020-08-12 |
| 1225646433 | Jasmine Reese | Counselor | 4625 Hope Valley Rd Apt A, Durham, NC 27707-6609 | 2020-07-14 |
| 1194352542 | Mariah Davis | Counselor | 1822 East Hwy Nc 54, Suite 300, Durham, NC 27713 | 2020-03-25 |
| 1508499815 | Abigail Garabrant | Counselor | 43 Kimberly Dr, Durham, NC 27707-5418 | 2020-02-14 |
| 1093347023 | Chancie Chaney | Counselor | 4 Boxwood Dr, Durham, NC 27713-9383 | 2020-02-07 |
| 1669004628 | Kira Danielle Parris-moore | Counselor | 525 Crossview Ln, Durham, NC 27703-6729 | 2020-02-07 |
| 1346872645 | Karen Lynn Moen | Counselor | 4600 University Dr Apt 1212, Durham, NC 27707-6121 | 2020-02-05 |
| Find all providers in DURHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.