Provider Demographics
NPI:1043916323
Name:STRONG START PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:STRONG START PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KULISH-AVERY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-608-4483
Mailing Address - Street 1:2310 S MIAMI BLVD STE 135
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-5799
Mailing Address - Country:US
Mailing Address - Phone:919-608-4483
Mailing Address - Fax:919-294-6534
Practice Address - Street 1:2310 S MIAMI BLVD STE 135
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-5799
Practice Address - Country:US
Practice Address - Phone:919-608-4483
Practice Address - Fax:919-294-6534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-07
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty