Healthcare Provider Details

I. General information

NPI: 1760391387
Provider Name (Legal Business Name): FAMILY PSYCHIATRY OF NORTH CAROLINA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 N MAPLE WALK DR
GARNER NC
27529-7837
US

IV. Provider business mailing address

17 N MAPLE WALK DR
GARNER NC
27529-7837
US

V. Phone/Fax

Practice location:
  • Phone: 984-263-7769
  • Fax: 315-887-1225
Mailing address:
  • Phone: 984-263-7769
  • Fax: 315-887-1225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: CECILE MATIP
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 315-726-4557