Provider Demographics
NPI:1215957691
Name:SHIGLEY, HAL (PHD)
Entity type:Individual
Prefix:DR
First Name:HAL
Middle Name:
Last Name:SHIGLEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3716 NATIONAL DR
Mailing Address - Street 2:SUITE 124
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4068
Mailing Address - Country:US
Mailing Address - Phone:919-783-8846
Mailing Address - Fax:919-783-7305
Practice Address - Street 1:3716 NATIONAL DR
Practice Address - Street 2:SUITE 124
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4068
Practice Address - Country:US
Practice Address - Phone:919-783-8846
Practice Address - Fax:919-783-7305
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0613103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7201798Medicaid
NC7201798Medicaid