Healthcare Provider Details

I. General information

NPI: 1235771312
Provider Name (Legal Business Name): WANG PSYCHOLOGICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

596 EXECUTIVE PL STE 102
FAYETTEVILLE NC
28305-5189
US

IV. Provider business mailing address

596 EXECUTIVE PL STE 102
FAYETTEVILLE NC
28305-5189
US

V. Phone/Fax

Practice location:
  • Phone: 910-758-1799
  • Fax: 910-460-9659
Mailing address:
  • Phone: 910-758-1799
  • Fax: 910-781-8700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MEI-CHUAN WANG
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 910-758-1799