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General NPI Number Information
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NPI Number | 1437637188
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Entity Type | Organization
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Legal Business Name | BRAD RAPPAPORT, PSY.D., PLLC
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Dates
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Enumeration Date | 08/04/2018
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Last Update Date | 08/04/2018
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Provider Practice Location Address
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Address Line | 8378 SIX FORKS RD STE 204
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City | RALEIGH
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State | NC
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Zip | 27615-5092
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Country | US
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Telephone | 917-297-5261
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Fax |
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Provider Business Mailing Address
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Address Line | 3013 GENTLE BREEZES LN
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City | RALEIGH
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State | NC
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Zip | 27614-7059
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Country | US
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Telephone | 917-297-5261
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/CLINICAL PSYCHOLOGIST
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Name | DR. BRAD RAPPAPORT
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Credential | PSY.D.
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Telephone | 917-297-5261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4483
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License Number State | NC
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