Provider Demographics
NPI:1285009712
Name:HELEN T BRANTLEY PHD PLLC
Entity Type:Organization
Organization Name:HELEN T BRANTLEY PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-316-9286
Mailing Address - Street 1:109 CONNER DR
Mailing Address - Street 2:SUITE #204
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7039
Mailing Address - Country:US
Mailing Address - Phone:919-933-0273
Mailing Address - Fax:919-240-5922
Practice Address - Street 1:109 CONNER DR
Practice Address - Street 2:SUITE #204
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7039
Practice Address - Country:US
Practice Address - Phone:919-933-0273
Practice Address - Fax:919-240-5922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0560103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty