| Therapeutic Resource Associates Pa | |
|
1618 Us Hwy 1 North Youngsville NC 27596-9219 | |
| (919) 247-4750 | |
| (919) 562-9917 |
| Full Name | Therapeutic Resource Associates Pa |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1618 Us Hwy 1 North, Youngsville, North Carolina |
| Authorized Official Name and Position | Angela H Phan (PRESIDENT) |
| Authorized Official Contact | 9192474750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Resource Associates Pa 1618 Us Hwy One North Youngsville NC 27596 Ph: (919) 247-4750 | Therapeutic Resource Associates Pa 1618 Us Hwy 1 North Youngsville NC 27596-9219 Ph: (919) 247-4750 |
| NPI Number | 1144396003 |
|---|---|
| Provider Enumeration Date | 11/24/2006 |
| Last Update Date | 06/24/2022 |
| Certification Date | 06/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144396003 | NPI | - | NPPES |
| 139TH | Other | NC | BCBS |
| 6107175 | Medicaid | NC | |
| 6005851 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2472 (North Carolina) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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