NPIMap

Organization Active NPI

Psychological Services of Raleigh, P.a.

  • Psychologist
  • Raleigh, NC
National Provider Identifier
1902940018
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
606 Issued in NC
Legal business name
PSYCHOLOGICAL SERVICES OF RALEIGH, P.A.
Practice address
4016 Barrett Dr
Suite 104
Raleigh, NC 27609-6623
Phone
(919) 781-5162
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mary Kilburn, PH.D.
Title
Owner
Phone
(919) 781-5162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 606 NC Primary

Addresses

Primary practice location

4016 Barrett Dr
Suite 104
Raleigh, NC 27609-6623

Mailing address

4016 Barrett Dr
Suite 104
Raleigh, NC 27609-6623

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902940018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 BARRETT DR",
            "address_2": "SUITE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 BARRETT DR",
            "address_2": "SUITE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096623",
            "telephone_number": "919-781-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL SERVICES OF RALEIGH, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KILBURN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-781-5162",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NC",
            "license": "606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.