Healthcare Provider Details

I. General information

NPI: 1043403728
Provider Name (Legal Business Name): LUCY M CHARTIER PH.D., PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5613 DURALEIGH RD SUITE 101
RALEIGH NC
27612-2694
US

IV. Provider business mailing address

5613 DURALEIGH RD SUITE 101
RALEIGH NC
27612-2694
US

V. Phone/Fax

Practice location:
  • Phone: 919-782-4597
  • Fax: 919-784-0089
Mailing address:
  • Phone: 919-782-4597
  • Fax: 919-784-0089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number126683
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5004126
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: