Healthcare Provider Details
I. General information
NPI: 1609288034
Provider Name (Legal Business Name): TRIANGLE PSYCHIATRY & WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2014
Last Update Date: 07/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1515 W NC HIGHWAY 54 STE 220
DURHAM NC
27707-5576
US
IV. Provider business mailing address
1603 W NC HIGHWAY 54
DURHAM NC
27707-5511
US
V. Phone/Fax
- Phone: 919-443-2341
- Fax: 919-869-1678
- Phone: 919-443-2341
- Fax: 919-869-1678
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0802X |
| Taxonomy | Addiction Psychiatry Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KELLY
ALLAN
SCHOFIELD
Title or Position: OWNER
Credential: M.D.
Phone: 919-308-4803