Healthcare Provider Details

I. General information

NPI: 1942652763
Provider Name (Legal Business Name): WHITNEY E. DRAPER, PSY.D., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 07/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 BLUE RIDGE RD STE 380
RALEIGH NC
27612-4650
US

IV. Provider business mailing address

4000 BLUE RIDGE RD STE 380
RALEIGH NC
27612-4650
US

V. Phone/Fax

Practice location:
  • Phone: 919-590-9937
  • Fax:
Mailing address:
  • Phone: 919-590-9937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. WHITNEY DRAPER
Title or Position: PSYCHOLOGIST
Credential:
Phone: 919-590-9937