Provider Information for 1518259779
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Ms. AMY J PROKOPOWICZ MA,LCAS, LPC, NCC
Sex: Female
NPI: 1518259779
Last Updated: 2024-08-28
Certification Date: 2024-08-28
Certification Date: 2024-08-28
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1518259779 | ||||||||||||
| Enumeration Date | 2011-05-06 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 112 COX AVE RALEIGH, NC 27605-6352 United States Phone: 919-443-5704 | Fax: | ||||||||||||
| Primary Practice Address | 180 MINE LAKE CT RALEIGH, NC 27615-6417 United States Phone: 919-273-1113 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 112 COX AVE | ||||||||||||
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