Provider Demographics
NPI:1790667061
Name:POPE, I-ASIA
Entity type:Individual
Prefix:
First Name:I-ASIA
Middle Name:
Last Name:POPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7209 STEPHEN BOYD CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-5642
Mailing Address - Country:US
Mailing Address - Phone:919-919-3623
Mailing Address - Fax:
Practice Address - Street 1:1005 BIG OAK CT STE A
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-6565
Practice Address - Country:US
Practice Address - Phone:919-679-3195
Practice Address - Fax:919-679-3195
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No174200000XOther Service ProvidersMeals
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health