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General NPI Number Information
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NPI Number | 1487841458
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Entity Type | Organization
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Legal Business Name | PSYCHLL INCORPORATED
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 01/11/2008
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Provider Practice Location Address
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Address Line | 111 CLOISTER CT STE 100
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City | CHAPEL HILL
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State | NC
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Zip | 27514-2295
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Country | US
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Telephone | 919-942-9574
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Fax | 919-403-5511
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Provider Business Mailing Address
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Address Line | 111 CLOISTER CT STE 100
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City | CHAPEL HILL
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State | NC
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Zip | 27514-2295
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Country | US
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Telephone | 919-942-9574
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Fax | 919-403-5511
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LEWIS LIPSITZ
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Credential | MSW
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Telephone | 919-942-9574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | NC-C002067
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License Number State | NC
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