=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558127597
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEE DOYLE THERAPY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2024
-----------------------------------------------------
Last Update Date | 03/04/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 521 TERRELL RD
-----------------------------------------------------
City | HILLSBOROUGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27278-2046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-408-7796
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 52694
-----------------------------------------------------
City | DURHAM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27717-2694
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-408-7796
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER, PSYCHOTHERAPIST
-----------------------------------------------------
Name | LEE DOYLE
-----------------------------------------------------
Credential | MSW, MPH, LCSWA
-----------------------------------------------------
Telephone | 919-408-7796
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------