Provider Demographics
NPI:1205158664
Name:NORTH RALEIGH MENTAL HEALTH, PA
Entity type:Organization
Organization Name:NORTH RALEIGH MENTAL HEALTH, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:BEASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-896-6998
Mailing Address - Street 1:920 PAVERSTONE DRIVE,
Mailing Address - Street 2:SUITE D
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615
Mailing Address - Country:US
Mailing Address - Phone:919-896-6998
Mailing Address - Fax:919-896-6414
Practice Address - Street 1:920 PAVERSTONE DRIVE,
Practice Address - Street 2:SUITE D
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615
Practice Address - Country:US
Practice Address - Phone:919-896-6998
Practice Address - Fax:919-896-6414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005001582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty