Healthcare Provider Details

I. General information

NPI: 1619044997
Provider Name (Legal Business Name): TRIANGLE FORENSIC PSYCHOLOGISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 REGENCY PKWY
CARY NC
27518-8549
US

IV. Provider business mailing address

2500 REGENCY PKWY
CARY NC
27518-8549
US

V. Phone/Fax

Practice location:
  • Phone: 919-629-7179
  • Fax: 919-629-7180
Mailing address:
  • Phone: 919-629-7179
  • Fax: 919-629-7180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3176
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number3176
License Number StateNC

VIII. Authorized Official

Name: DR. PETER D SCHULZ
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 919-629-7179