Provider Demographics
NPI:1568583763
Name:NICOLE A. ENGEL, PH.D., P..C.
Entity Type:Organization
Organization Name:NICOLE A. ENGEL, PH.D., P..C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-990-1109
Mailing Address - Street 1:1502 W NC HIGHWAY 54
Mailing Address - Street 2:SUITE 603
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5571
Mailing Address - Country:US
Mailing Address - Phone:919-990-1109
Mailing Address - Fax:919-419-3110
Practice Address - Street 1:1502 W NC HIGHWAY 54
Practice Address - Street 2:SUITE 603
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-5571
Practice Address - Country:US
Practice Address - Phone:919-990-1109
Practice Address - Fax:919-419-3110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2264103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0429JOtherBCBS PIN