Healthcare Provider Details

I. General information

NPI: 1689852360
Provider Name (Legal Business Name): HILLSBOROUGH PSYCHIATRY & PSYCHOTHERAPY ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 CORPORATE DR SUITE 402
HILLSBOROUGH NC
27278-8558
US

IV. Provider business mailing address

960 CORPORATE DR SUITE 402
HILLSBOROUGH NC
27278-8558
US

V. Phone/Fax

Practice location:
  • Phone: 919-732-2130
  • Fax:
Mailing address:
  • Phone: 919-732-2130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY JANE ENDRES
Title or Position: PARTNER
Credential: LCSW
Phone: 919-732-2130