Healthcare Provider Details

I. General information

NPI: 1538537519
Provider Name (Legal Business Name): BEST DAY PSYCHIATRY AND COUNSELING, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 ATTAIN ST STE 101
FUQUAY VARINA NC
27526-1984
US

IV. Provider business mailing address

2587 RAVENHILL DR
FAYETTEVILLE NC
28303-5451
US

V. Phone/Fax

Practice location:
  • Phone: 919-567-0684
  • Fax:
Mailing address:
  • Phone: 910-323-1545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberA9626
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3148
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC009047
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number144494
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number200201282
License Number StateNC

VIII. Authorized Official

Name: ROBERT K MATLACK
Title or Position: OWNER
Credential: MD
Phone: 910-323-1543