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General NPI Number Information
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NPI Number | 1124210034
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Entity Type | Organization
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Legal Business Name | RALEIGH PSYCHOLOGY AND COUNSELING, PA
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 08/14/2007
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Provider Practice Location Address
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Address Line | 8524 SIX FORKS RD SUITE 203
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City | RALEIGH
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State | NC
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Zip | 27615-3099
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Country | US
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Telephone | 919-845-7445
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Fax | 919-845-7443
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Provider Business Mailing Address
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Address Line | 8524 SIX FORKS RD SUITE 203
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City | RALEIGH
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State | NC
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Zip | 27615-3099
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Country | US
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Telephone | 919-845-7445
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Fax | 919-845-7443
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST/OWNER
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Name | DR. STEPHEN JOHN FLANNELLY
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Credential | PH.D. PSYCHOLOGIST
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Telephone | 919-845-7445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | HSP-P #2253
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License Number State | NC
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