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NPI Code Detail

MEDICARE: EPIC INTEGRATIVE HEALTH SERVICES, PLLC

MEDICARE: EPIC INTEGRATIVE HEALTH SERVICES, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center
2261QM0855XAdolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number : 1609503473
Entity Type Code : Organization
Provider Name (Legal Business Name) : EPIC INTEGRATIVE HEALTH SERVICES, PLLC
Provider Business Mailing Address
First Line : 6409 FAYETTEVILLE RD SUITE 120 #119
Second Line :
City : DURHAM
State : NC
Zip : 27713
Country : US
Telephone Number : 984-259-9359
Fax Number :
Provider Business Practice Location Address
First Line : 4804 PAGE CREEK LN STE 212
Second Line :
City : DURHAM
State : NC
Zip : 27703-8582
Country : US
Telephone Number : 984-259-9359
Fax Number :
Authorized Official
Title or Position : LCSW
Name : ERICA A LILES
Credential : LCSW
Telephone Number : 919-698-8202
Provider Enumeration Date : 08/02/2022
Last Update Date : 08/02/2022

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Directions to “EPIC INTEGRATIVE HEALTH SERVICES, PLLC ” Practice Location

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