Healthcare Provider Details

I. General information

NPI: 1477030872
Provider Name (Legal Business Name): THERAPY TREE SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2018
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PINNER WEALD WAY STE 201
CARY NC
27513-2601
US

IV. Provider business mailing address

600 PINNER WEALD WAY STE 201
CARY NC
27513-2601
US

V. Phone/Fax

Practice location:
  • Phone: 919-348-9174
  • Fax: 919-375-2538
Mailing address:
  • Phone: 919-348-9174
  • Fax: 919-375-2538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number10406
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MEGHAN BATEMAN
Title or Position: OWNER/SPEECH LANGUAGE PATHOLOGIST
Credential: MS, CCC-SLP
Phone: 919-348-9174