Wake Psychological Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2119 Issued in NC

Legal business name

WAKE PSYCHOLOGICAL SERVICES

Practice address

1612 Barony Lake Way
Raleigh, NC 27614-8478

Phone

(919) 308-8470

NPI assigned

Jun 25, 2014

Last updated

Jun 25, 2014By 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

Tijuana Crosby

Title

President

Phone

(919) 308-8470

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1760897094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 BARONY LAKE WAY",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 BARONY LAKE WAY",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148478",
            "telephone_number": "919-308-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-25",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "CROSBY",
        "authorized_official_first_name": "TIJUANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-308-8470"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "2119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wake Medical Laboratory Consultants Inc
• Wake Medical Supply LLC
• Wake Nephrology Associates, P.a.
• Wake Orthopaedics, LLC
• Wake Psychiatry, PLLC
• Wake Psychological Services, PLLC
• Wake Radiology Consultants PA
• Wake Radiology Diagnostic Imaging Inc.
• Wake Radiology Services, LLC
• Wake Rheumatology & Osteoporosis (Wake Rheumatology &Osteoporosis Consultants, P.A.)

• Community/Behavioral Health Agency in Raleigh, NC
• Providers in Raleigh, 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 25, 2014; 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.