Provider Demographics
NPI:1467921684
Name:FLOYD PSYCHOTHERAPY & CLINICAL CONSULTING PLLC
Entity Type:Organization
Organization Name:FLOYD PSYCHOTHERAPY & CLINICAL CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RENAE
Authorized Official - Middle Name:LANETTE
Authorized Official - Last Name:EADES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, SAP
Authorized Official - Phone:910-264-9779
Mailing Address - Street 1:107 KNIGHTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6339
Mailing Address - Country:US
Mailing Address - Phone:910-264-9779
Mailing Address - Fax:919-746-7449
Practice Address - Street 1:2530 MERIDIAN PKWY STE 3104
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-5272
Practice Address - Country:US
Practice Address - Phone:919-251-6973
Practice Address - Fax:919-746-7449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty