Therapeutic Resource Associates PA

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THERAPEUTIC RESOURCE ASSOCIATES PA

Practice address

1618 US Hwy 1 North
Youngsville, NC 27596-9219

Phone

(919) 247-4750

Fax

(919) 562-9917

NPI assigned

Nov 24, 2006

Last updated

Jun 24, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angela H Phan, MA, LPANPI 1720100746

Title

President

Phone

(919) 247-4750

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angela Phan, MA, LPA

  • Psychologist
  • Youngsville, NC
  • NPI 1720100746
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656028800000",
    "number": "1144396003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 US HWY ONE NORTH",
            "city": "YOUNGSVILLE",
            "state": "NC",
            "postal_code": "27596",
            "telephone_number": "919-247-4750",
            "fax_number": "919-562-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 US HWY 1 NORTH",
            "city": "YOUNGSVILLE",
            "state": "NC",
            "postal_code": "275969219",
            "telephone_number": "919-247-4750",
            "fax_number": "919-562-9917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC RESOURCE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-247-4750",
        "authorized_official_credential": "MA, LPA"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NC",
            "license": "2472",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "139TH",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6107175",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005851",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Youngsville, NC
• Providers in Youngsville, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.