Organization Active NPI

Psychological Health Associates, PA

  • Clinical Child & Adolescent Psychologist
  • Cary, NC
National Provider Identifier
1417904137
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
751 Issued in NC
Legal business name
PSYCHOLOGICAL HEALTH ASSOCIATES, PA
Practice address
102 Commonwealth CT
Ste H
Cary, NC 27511-4437
Phone
(919) 467-2876
Fax
(919) 467-6871
NPI assigned
May 28, 2006
Last updated
Mar 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Authorized official

Name
Dr. Paul R Krasner, PHDNPI 1306994439
Title
President
Phone
(919) 467-2876

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 751 NC Primary

Addresses

Primary practice location

102 Commonwealth CT
Ste H
Cary, NC 27511-4437

Mailing address

102 Commonwealth CT
Ste H
Cary, NC 27511-4437
Phone (919) 467-2876

Other identifiers 1

IdentifierTypeStateIssuer
0267GOtherNCBLUE CROSS/ BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1417904137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 COMMONWEALTH CT",
            "address_2": "STE H",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114437",
            "telephone_number": "919-467-2876",
            "fax_number": "919-467-6871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 COMMONWEALTH CT",
            "address_2": "STE H",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114437",
            "telephone_number": "919-467-2876",
            "fax_number": "919-467-6871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL HEALTH ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "KRASNER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-467-2876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NC",
            "license": "751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "0267G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; 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.