Healthcare Provider Details
I. General information
NPI: 1699603753
Provider Name (Legal Business Name): PSYCH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9121 ANSON WAY STE 200
RALEIGH NC
27615-5857
US
IV. Provider business mailing address
9121 ANSON WAY STE 200
RALEIGH NC
27615-5857
US
V. Phone/Fax
- Phone: 984-248-6362
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALVIN
PARKER
IV
Title or Position: CEO
Credential: MD
Phone: 984-248-6362