| White Oak Psychological Services, Inc | |
|
1405 Hillsborough St Suite 205 Raleigh NC 27605-1828 | |
| (919) 438-0060 | |
| (919) 694-0082 |
| Full Name | White Oak Psychological Services, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 1405 Hillsborough St, Raleigh, North Carolina |
| Authorized Official Name and Position | Hollister Wooten Trott (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 9194380060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| White Oak Psychological Services, Inc 515 Barksdale Dr Raleigh NC 27604-2203 Ph: (919) 794-1157 | White Oak Psychological Services, Inc 1405 Hillsborough St Suite 205 Raleigh NC 27605-1828 Ph: (919) 438-0060 |
| NPI Number | 1184163925 |
|---|---|
| Provider Enumeration Date | 02/13/2017 |
| Last Update Date | 07/23/2022 |
| Certification Date | 07/23/2022 |
| Medicare PECOS PAC ID | 9032496005 |
|---|---|
| Medicare Enrollment ID | O20170428000720 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184163925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 4564 (North Carolina) | Primary |
| Provider Name | Hollister W Trott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447500087 PECOS PAC ID: 6103043039 Enrollment ID: I20150327002378 |
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