PRIVATE DIAGNOSTIC CLINIC, PLLC (NPI# 1093265241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093265241 |
| Entity Type | Organization |
| Organization Name | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | PSYCHIATRY ERWIN SQUARE |
| Practice Address |
2200 W Main St Ste 340 Durham NC 27705-4640 |
| Mailing Address |
Po Box 63362 Charlotte NC 28263-3362 |
| Practice Telephone | 9194163439 |
| Mailing Telephone | 9194163439 |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2016-10-12 |
| Authorized Official Name | CHRISTOPHER T FREDERICK (CFO) |
| Authorized Official Telephone | 9196204918 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Psychiatry Erwin Square | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538616289 | Private Diagnostic Clinic, Pllc | Neurological Surgery | 1212 Cedarhurst Dr Ste 102, Raleigh, NC 27609-5588 | 2016-09-09 |
| 1083168181 | Private Diagnostic Clinic, Pllc | Internal Medicine | 10207 Cerny St Ste 306, Raleigh, NC 27617-4879 | 2016-08-08 |
| 1124459292 | Private Diagnostic Clinic, Pllc | Occupational Therapist | Duke Clinic 1e, 40 Duke Medicine Circle, Durham, NC 27710-0001 | 2013-11-27 |
| 1609116664 | Private Diagnostic Clinic, Pllc | Dermatology | 82 Wheaton Ave, Youngsville, NC 27596-8691 | 2013-02-27 |
| 1487903423 | Private Diagnostic Clinic, Pllc | Pediatrics | 540 New Waverly Place, Ste.101, Cary, NC 27518-7422 | 2012-09-06 |
| 1558639864 | Private Diagnostic Clinic, Pllc | Allergy & Immunology | 30 Duke Medicine Circle, Durham, NC 27710-3000 | 2011-12-01 |
| 1972826568 | Private Diagnostic Clinic, Pllc | Family Medicine | 800 Clayton Rd, Durham, NC 27703-2606 | 2010-03-10 |
| 1891021853 | Private Diagnostic Clinic, Pllc | Obstetrics & Gynecology | 2406 Blue Ridge Road, Suite 200, Raleigh, NC 27607-6680 | 2009-10-27 |
| 1447480413 | Private Diagnostic Clinic, Pllc | Orthopaedic Surgery | 511 Ruin Road, Suite 106, Henderson, NC 27536-5919 | 2009-07-23 |
| 1841446762 | Private Diagnostic Clinic, Pllc | Otolaryngology | 783 Doctors Ct Ste C, Roxboro, NC 27573-4575 | 2008-08-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRIVATE DIAGNOSTIC CLINIC, PLLC | Duke University Medical Center, Durham, NC 27710-0001 |
| Street Address |
2200 W MAIN ST STE 340 |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-4640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255330254 | Dale D. Stewart | Optometrist | 2200 W Main St, #a160, Durham, NC 27705-4640 | 2005-07-20 |
| 1003106295 | Kate Thieda | Counselor | 2200 W Main St, Suite 400a, Durham, NC 27705-4640 | 2011-04-09 |
| 1073778197 | Rhonda Marie Merwin | Psychiatry & Neurology | 2200 W Main St, Durham, NC 27705-4640 | 2008-07-29 |
| 1104081231 | Elizabeth Vanvoorhees | Psychiatry & Neurology | 2200 W Main St, Durham, NC 27705-4640 | 2008-07-29 |
| 1043377492 | Andrew S Silberman | Social Worker | 2200 W Main St, Suite 700, Durham, NC 27705-4640 | 2007-01-03 |
| 1134281736 | Woodhall Stopford | Preventive Medicine | 2200 W Main St, Suite 600, Durham, NC 27705-4640 | 2006-12-14 |
| 1083629745 | Judith Claire Holder-cooper | Psychologist | 2200 W Main St, Suite 400a, Durham, NC 27705-4640 | 2006-07-30 |
| 1760497424 | Duke University | Psychologist | 2200 W Main St, Suite 400a, Durham, NC 27705-4640 | 2006-07-30 |
| 1588619050 | Barbara Delafield Eldredge | Psychologist | 2200 W Main St, Suite 400a, Durham, NC 27705-4640 | 2006-05-23 |
| 1043272511 | Daphne Connelly Mckee | Psychologist | 2200 W Main St, Durham, NC 27705-4640 | 2006-04-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
| 1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
| 1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
| 1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
| 1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
| Find all providers in zip 27705 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861033839 | Hope Inga Hills | Psychologist | 1118 Scholastic Cir, Durham, NC 27713-6580 | 2019-10-01 |
| 1336704808 | Rachel Bradley | Psychologist | 1415 W Nc Highway 54 Ste 210, Durham, NC 27707-5597 | 2019-05-09 |
| 1033620620 | Beverly H Savinsky | Psychologist | 4125 Ben Franklin Blvd Ste 160, Durham, NC 27704-2167 | 2017-10-23 |
| 1134659105 | Center for Health and Emotional Wellness, Pllc | Psychologist | 4819 Emperor Blvd Ste 400, Durham, NC 27703-5420 | 2017-06-13 |
| 1053843532 | Warren Eugene Hoskins II | Psychologist | 2611 Camellia Dr, Durham, NC 27705-2075 | 2017-04-03 |
| 1558778332 | Shiahna Dye | Psychologist | 3200 Old Chapel Hill Rd, Durham, NC 27707-3606 | 2014-07-14 |
| 1902226699 | Tonya Omar Pllc Dba The Aya Center | Psychologist | 3500 Westgate Dr Ste 101, Durham, NC 27707-2568 | 2014-04-21 |
| 1316373871 | Elizabeth Ann Schmitt | Psychologist | 414 Gresham Ave, Durham, NC 27704-4214 | 2013-09-16 |
| 1457792830 | Tracy Cannady | Psychologist | 3308 Durham Chapel Hill Blvd Ste F, Durham, NC 27707-6200 | 2013-07-12 |
| 1912346339 | Jennifer Carolyn Plumb Vilardaga | Psychologist | 2200 W Main St Ste 340, Durham, NC 27705-4677 | 2013-06-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.