Provider Demographics
NPI:1528432820
Name:ROUND TABLE PSYCHOLOGICAL AND EDUCATIONAL SERVICES
Entity type:Organization
Organization Name:ROUND TABLE PSYCHOLOGICAL AND EDUCATIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOKS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:919-704-0708
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-0099
Mailing Address - Country:US
Mailing Address - Phone:919-704-0708
Mailing Address - Fax:
Practice Address - Street 1:600 S CAMELLIA ST
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-6028
Practice Address - Country:US
Practice Address - Phone:919-704-0708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4721251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health