Provider Demographics
NPI:1992488225
Name:BUSIO, ILARIA GIULIANA (LCMHC-A)
Entity type:Individual
Prefix:
First Name:ILARIA
Middle Name:GIULIANA
Last Name:BUSIO
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5510 SIX FORKS RD STE 125
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-3884
Mailing Address - Country:US
Mailing Address - Phone:919-861-4111
Mailing Address - Fax:
Practice Address - Street 1:5510 SIX FORKS RD STE 125
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3884
Practice Address - Country:US
Practice Address - Phone:919-861-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19079101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health