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NPI Code Detail

MEDICARE: BRAD PRINZHORN

MEDICARE: BRAD PRINZHORN
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
1103T00000XPsychologist2789NC
2101YM0800XMental Health Counselor2789NC
3103TC0700XClinical Psychologist2789NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982682910
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRAD PRINZHORN
Provider Business Mailing Address
First Line : 2670 DURHAM CHAPEL HILL BLVD
Second Line :
City : DURHAM
State : NC
Zip : 27707-2829
Country : US
Telephone Number : 919-251-9001
Fax Number : 919-251-9008
Provider Business Practice Location Address
First Line : 2670 DURHAM CHAPEL HILL BLVD
Second Line :
City : DURHAM
State : NC
Zip : 27707-2829
Country : US
Telephone Number : 919-251-9001
Fax Number : 919-251-9008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2006
Last Update Date : 11/01/2013

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Directions to “ BRAD PRINZHORN ” Practice Location

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