| Cape Fear Developmental Therapies, Pllc | |
|
2601 Iron Gate Dr Ste 101 Wilmington NC 28412-6624 | |
| (910) 202-9113 | |
| (910) 202-9289 |
| Full Name | Cape Fear Developmental Therapies, Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2601 Iron Gate Dr Ste 101, Wilmington, North Carolina |
| Authorized Official Name and Position | Karen S. Kirk (OWNER / MANAGER) |
| Authorized Official Contact | 9102029113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cape Fear Developmental Therapies, Pllc P.o. Box 16570 Wilmington NC 28408 Ph: (910) 202-9113 | Cape Fear Developmental Therapies, Pllc 2601 Iron Gate Dr Ste 101 Wilmington NC 28412-6624 Ph: (910) 202-9113 |
| NPI Number | 1588912513 |
|---|---|
| Provider Enumeration Date | 08/23/2012 |
| Last Update Date | 10/06/2022 |
| Certification Date | 09/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588912513 | NPI | - | NPPES |
| 6008801 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3894 (North Carolina) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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