Provider Demographics
NPI:1013377563
Name:Q1 CLINICAL CONSULTANTS, LLC
Entity Type:Organization
Organization Name:Q1 CLINICAL CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MATISHA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:919-303-5377
Mailing Address - Street 1:856 TIMBER DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-4850
Mailing Address - Country:US
Mailing Address - Phone:919-303-5377
Mailing Address - Fax:919-303-5380
Practice Address - Street 1:2216 GRANDE VALLEY CIR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-3143
Practice Address - Country:US
Practice Address - Phone:919-303-5377
Practice Address - Fax:919-303-5380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418501Medicaid