Provider Demographics
NPI:1467409391
Name:WILLIAM H. VARLEY PH.D. PC
Entity Type:Organization
Organization Name:WILLIAM H. VARLEY PH.D. PC
Other - Org Name:PIEDMONT PSYCHOLOGICAL ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:VARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:704-861-0271
Mailing Address - Street 1:1536 UNION RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2204
Mailing Address - Country:US
Mailing Address - Phone:704-861-0271
Mailing Address - Fax:704-861-0374
Practice Address - Street 1:1536 UNION RD
Practice Address - Street 2:SUITE C
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2204
Practice Address - Country:US
Practice Address - Phone:704-861-0271
Practice Address - Fax:704-861-0374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0692103T00000X
NC908103TC0700X
NC0162103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC249030AMedicare PIN