| Northridge Psychological Service Pc | |
|
2301 Stonehenge Dr Ste 202 Raleigh NC 27615-4378 | |
| (919) 847-2197 | |
| (919) 846-7748 |
| Full Name | Northridge Psychological Service Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2301 Stonehenge Dr Ste 202, Raleigh, North Carolina |
| Authorized Official Name and Position | James Thomas English (OWNER) |
| Authorized Official Contact | 9198472197 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northridge Psychological Service Pc 2301 Stonehenge Dr Ste 202 Raleigh NC 27615-4378 Ph: (919) 847-2197 | Northridge Psychological Service Pc 2301 Stonehenge Dr Ste 202 Raleigh NC 27615-4378 Ph: (919) 847-2197 |
| NPI Number | 1114127024 |
|---|---|
| Provider Enumeration Date | 07/19/2007 |
| Last Update Date | 07/19/2007 |
| Medicare PECOS PAC ID | 3274624200 |
|---|---|
| Medicare Enrollment ID | O20081023000673 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114127024 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 1417 (North Carolina) | Primary |
| Provider Name | James T English |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871520270 PECOS PAC ID: 6002910866 Enrollment ID: I20081023000662 |
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