NORTHRIDGE PSYCHOLOGICAL SERVICE PC (NPI# 1114127024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114127024 |
| Entity Type | Organization |
| Organization Name | NORTHRIDGE PSYCHOLOGICAL SERVICE PC |
| Practice Address |
2301 Stonehenge Dr Ste 202 Raleigh NC 27615-4378 |
| Practice Telephone | 9198472197 |
| Practice Fax Number | 9198467748 |
| Mailing Telephone | 9198472197 |
| Mailing Fax Number | 9198467748 |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |
| Authorized Official Name | JAMES THOMAS ENGLISH (OWNER) |
| Authorized Official Telephone | 9198472197 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
1417 | NC | Ambulatory Health Care Facilities |
| Street Address |
2301 STONEHENGE DR STE 202 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27615-4378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588278535 | Emily Grace Johnson | Behavior Technician | 119 Wind Chime Court, Suite 4, Raleigh, NC 27615 | 2020-09-06 |
| 1730706110 | Maja V Martin, Dds, Pa1 | Clinic/Center | 7371 Six Forks Road, Raleigh, NC 27615 | 2020-07-01 |
| 1972146967 | Atlantic Avenue Pharmaceutical, Inc | Pharmacy | 5621 Atlantic Ave, Suite 103, Raleigh, NC 27615 | 2019-10-22 |
| 1023503950 | Siyara Shannay Dobbs | Social Worker | 7013 Woodbend Dr Apt H, Raleigh, NC 27615 | 2018-06-23 |
| 1194210153 | Brittanie Ja'nell Harris | Dentist | 1911 Falls Valley Dr Ste 107, Raleigh, NC 27615 | 2018-06-22 |
| 1710489448 | Sherise Swensen | Social Worker | 8368 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2018-03-08 |
| 1881100345 | Casey Paul Baine | Counselor | 6330 Falls of Neuse Rd Ste 104, Raleigh, NC 27615 | 2017-12-20 |
| 1588177885 | Michael Lacidonia | Acupuncturist | 6400 Falls of Neuse Rd Ste 200, Raleigh, NC 27615 | 2017-11-08 |
| 1457877631 | Matt Henderson | Behavioral Analyst | 8374 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2017-08-18 |
| 1760907646 | Shakeda Muldrow | Social Worker | 7323 Brookbank Lane, Raleigh, NC 27615 | 2017-08-11 |
| Find all providers in zip 27615 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710540984 | Dandelion Counseling Services Pllc | Clinic/Center | 4909 Waters Edge Dr Ste 100d, Raleigh, NC 27606-2462 | 2019-04-15 |
| 1730576992 | Harrison Group Homes LLC | Clinic/Center | 2609 Fernbrook Rd, Raleigh, NC 27610-3507 | 2015-04-24 |
| 1144586827 | Region Ten Commission On Mental Health | Clinic/Center | 355 Hwy 37 South, Raleigh, MS 39153-0355 | 2012-04-06 |
| 1013243583 | Heaven Sent | Clinic/Center | 3112 Berry Court., Raleigh, NC 27610 | 2009-10-19 |
| 1457519514 | Adolescent,child & Adult Psychiatry | Clinic/Center | 4041 Ed Dr # 108, Raleigh, NC 27612-8089 | 2008-05-27 |
| 1033383963 | Compassionate Place Home Inc. | Clinic/Center | 3401 Sheryl Dr, Raleigh, NC 27604-4152 | 2008-04-22 |
| 1407040785 | Victory Healthcare Services, Inc | Clinic/Center | 3716 Summer Pl, Raleigh, NC 27604-4252 | 2007-08-30 |
| 1841327525 | Lindas Family Care Home | Clinic/Center | 816 Peyton Street, Raleigh, NC 27610-3544 | 2007-02-28 |
| 1386771657 | Cottage Health Care Services, Inc | Clinic/Center | 3826 Bland Rd, Raleigh, NC 27609-6239 | 2007-02-27 |
| 1043346273 | Worthdale Family Care | Clinic/Center | 933 Friar Tuck Rd, Raleigh, NC 27610-3634 | 2007-02-23 |
| Find all providers in RALEIGH | ||||
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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.