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EZEKIEL WILSON
NPI 1689918641
Counselor - Mental Health in Raleigh, NC

Active since November 15, 2012
311 NEW BERN AVE, # 27991, RALEIGH, NC 27611(919) 961-1392 Get Directions Write a Review

NPPES record last updated: November 15, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ezekiel Wilson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EZEKIEL WILSON (NPI 1689918641) is a healthcare organization registered as a mental health in Raleigh, North Carolina and active in the NPI registry since November 2012. The organization lists Ezekiel Wilson, Owner, as its authorized official.

NPPES Registry Identity

NPI1689918641
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameCREECH ROAD SUPERVISED GARE
Location Address311 NEW BERN AVE, # 27991Raleigh, NC 27611-0801
Mailing Address808 Creech RdGarner, NC 27529-2916 · (919) 961-1392
Phone(919) 961-1392
Organization SubpartNo
Authorized OfficialEzekiel WilsonOwner · (919) 961-1392
Enumeration DateNovember 15, 2012
✔ NPI 1689918641 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NC · MHL 092761
311 NEW BERN AVE, Raleigh, NC 27611
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Other Names 1

Doing Business AsEzekiel Wilson

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Creech Road Supervised Gare's NPI number?

The NPI number for Creech Road Supervised Gare is 1689918641. It was assigned to this organization in the NPPES registry on November 15, 2012. The provider is doing business as Ezekiel Wilson.

Where is Creech Road Supervised Gare located?

Creech Road Supervised Gare is located at 311 New Bern Ave # 27991, Raleigh, NC 27611. The listed phone number is (919) 961-1392.

What is Creech Road Supervised Gare's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Creech Road Supervised Gare was last updated on November 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.