Provider Demographics
NPI:1588475289
Name:SERRANO OTERO, JOSHUA (LPC, LCMHC-A, NCC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:SERRANO OTERO
Suffix:
Gender:M
Credentials:LPC, LCMHC-A, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 BELMONT DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-2467
Mailing Address - Country:US
Mailing Address - Phone:919-824-7907
Mailing Address - Fax:
Practice Address - Street 1:901 BELMONT DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-2467
Practice Address - Country:US
Practice Address - Phone:919-824-7907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1727162101YP2500X
NCA19454101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional