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8450 Falls Of Neuse Rd Ste 200 Raleigh NC 27615-3549 | |
| (919) 418-1718 | |
| (919) 794-5715 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 8450 Falls Of Neuse Rd Ste 200, Raleigh, North Carolina |
| Authorized Official Name and Position | Tonya D. Armstrong (PRESIDENT) |
| Authorized Official Contact | 9194181718 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8450 Falls Of Neuse Rd Ste 200 Raleigh NC 27615-3549 Ph: (919) 418-1718 | 8450 Falls Of Neuse Rd Ste 200 Raleigh NC 27615-3549 Ph: (919) 418-1718 |
| NPI Number | 1235264730 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 11/24/2020 |
| Certification Date | 11/24/2020 |
| Medicare PECOS PAC ID | 9335565712 |
|---|---|
| Medicare Enrollment ID | O20200817000211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235264730 | NPI | - | NPPES |
| 6000209 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2708 (North Carolina) | Secondary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 2708 (North Carolina) | Primary |
| Provider Name | Tonya D Armstrong |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164643763 PECOS PAC ID: 5799101176 Enrollment ID: I20200817000295 |
| Provider Name | Kim Nichols |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1588217004 PECOS PAC ID: 1456892710 Enrollment ID: I20240926001651 |
| Provider Name | Clifton Dale Garner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699353490 PECOS PAC ID: 8527599828 Enrollment ID: I20240926003469 |
| Provider Name | Melanie Mcintyre |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932870094 PECOS PAC ID: 9436680741 Enrollment ID: I20240926003949 |
| Provider Name | Reginald Calvert Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720619414 PECOS PAC ID: 8527590348 Enrollment ID: I20241017004439 |
| Provider Name | Anthony F. Greene |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730144817 PECOS PAC ID: 3476087461 Enrollment ID: I20241113003196 |
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