Elwood Johnson Burgess in Raleigh - Clinical Child & Adolescent
Elwood Johnson Burgess - NPI 1265644637
Elwood Johnson Burgess is a Clinical Child & Adolescent in Raleigh, North Carolina. Elwood Johnson Burgess practices all healthcare services and medical treatments related to Clinical Child & Adolescent. The NPI Number for Elwood Johnson Burgess is 1265644637. The last update date is 2018-05-26.
Elwood Johnson Burgess's current location address is 3509 Haworth Dr, Raleigh, North Carolina. You can contact this provider via phone number 9197859944 and fax number 9197859992. The mailing address for Elwood Johnson Burgess is 3509 Haworth Dr, Raleigh, North Carolina. To know further, please read the information below!
Provider Profile Detail
Provider Name | Elwood Johnson Burgess |
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Address | 3509 Haworth Dr, Raleigh, North Carolina |
Phone Number | 9197859944 |
Fax Number | 9197859992 |
Sole Proprietor | Y |
Credentials | PSY.D. |
NPI Number Detail
NPI Number | 1265644637 |
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Provider Enumeration Date | 2007-05-05 |
Last Updated Date | 2018-05-26 |
Provider Mailing Address Detail
Address | 3509 Haworth Dr |
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City | Raleigh |
State | North Carolina (NC) |
Post Code | 276097237 |
Phone Number | 9197859944 |
Fax Number | 9197859992 |
Provider's Primary Taxonomy Detail
Speciality | Clinical Child & Adolescent |
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Taxonomy | 103Tc2200X |
Licence No | 2249 |
Definition: A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
0310E | NC | BCBSNC | |
176TU | NC | BC/BS EFF 2/1/2013 | |
6000342 | NC | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Elwood Johnson Burgess by the Centers for Medicare & Medicaid Services?
The Elwood Johnson Burgess has been assigned the NPI (National Provider Identifier) 1265644637 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Elwood Johnson Burgess?
The Elwood Johnson Burgess is situated at 3509 Haworth Dr, in the city of Raleigh, state of NC, with the zip code 276097237.
What is Elwood Johnson Burgess's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Elwood Johnson Burgess is Clinical Child & Adolescent, and the taxonomy code that categorizes this field of expertise is 103Tc2200X.
On what date did the Centers for Medicare & Medicaid Services issue the 1265644637 to Elwood Johnson Burgess?
The Elwood Johnson Burgess received its 1265644637 assignment from the Centers for Medicare & Medicaid Services on 2007-05-05.
When was the information pertaining to Elwood Johnson Burgess most recently updated or revised?
The details related to Elwood Johnson Burgess, including its address, specialty, and other relevant information, were last updated or revised on 2018-05-26.