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General NPI Number Information
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NPI Number | 1629499819
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Entity Type | Organization
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Legal Business Name | BAY AREA PSYCHOLOGY ASSOCIATES, PLLC
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Dates
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Enumeration Date | 12/14/2013
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 2457 GUM BRANCH RD STE 800
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City | JACKSONVILLE
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State | NC
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Zip | 28540-4008
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Country | US
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Telephone | 910-238-2774
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Fax | 910-387-0757
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Provider Business Mailing Address
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Address Line | 2457 GUM BRANCH RD STE 800
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City | JACKSONVILLE
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State | NC
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Zip | 28540-4008
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Country | US
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Telephone | 910-238-2774
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Fax | 910-387-0757
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | ALLISON BROOKS
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Credential |
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Telephone | 910-581-5352
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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