Provider Demographics
NPI:1376911917
Name:PITTSBORO PEDIATRIC PSYCHOLOGY AND ADHD CLINIC
Entity Type:Organization
Organization Name:PITTSBORO PEDIATRIC PSYCHOLOGY AND ADHD CLINIC
Other - Org Name:SCHEFFLER PSYCHOLOGICAL ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:BREWIS
Authorized Official - Last Name:SCHEFFLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-548-5612
Mailing Address - Street 1:PO BOX 1372
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-1372
Mailing Address - Country:US
Mailing Address - Phone:919-548-5612
Mailing Address - Fax:919-535-9247
Practice Address - Street 1:290 EAST ST STE 106
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-8863
Practice Address - Country:US
Practice Address - Phone:919-548-5612
Practice Address - Fax:919-535-9247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2634103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1629016605OtherINDIVIDUAL NPI