Provider Demographics
NPI:1386240794
Name:BLUE RIDGE BEHAVIORAL HEALTH & TRAUMA RECOVERY PLLC
Entity type:Organization
Organization Name:BLUE RIDGE BEHAVIORAL HEALTH & TRAUMA RECOVERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OUTPATIENT PSYCH
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:E
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-791-7545
Mailing Address - Street 1:7031 US HIGHWAY 221 S
Mailing Address - Street 2:
Mailing Address - City:BLOWING ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28605-9988
Mailing Address - Country:US
Mailing Address - Phone:919-791-7545
Mailing Address - Fax:919-747-4257
Practice Address - Street 1:1135 KILDAIRE FARM RD STE 200
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4587
Practice Address - Country:US
Practice Address - Phone:919-791-7545
Practice Address - Fax:919-747-4257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty