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PRIVATE DIAGNOSTIC CLINIC PLLC NPI 1649757568


NPI Information

NPI: 1649757568
Provider Name: PRIVATE DIAGNOSTIC CLINIC, PLLC
Classification: Psychologist - 103T00000X
Entity Type: Organization

CLIA Number: 34D2022752

Address:
40 DUKE MEDICINE CIR
DURHAM, NC
ZIP 27710
Phone: (919) 620-4700
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PRIVATE DIAGNOSTIC CLINIC, PLLC is a psychologist in Durham, NC. The provider is a psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. PRIVATE DIAGNOSTIC CLINIC, PLLC NPI is 1649757568. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

40 DUKE MEDICINE CIR
DURHAM, NC
ZIP 27710-000
Phone: (919) 620-4700

The provider's authorized official is Christopher Thomas Frederick .
The authorized official title is Cfo and has the following contact phone number (919) 613-7762.

The CLIA number assigned to this NPI record is 34D2022752 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/24/2018 and was last updated on 7/11/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103T00000XPsychologistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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