Provider Demographics
NPI:1679358667
Name:CORE4 PSYCHOLOGY, PLLC
Entity Type:Organization
Organization Name:CORE4 PSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LEBO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-360-2495
Mailing Address - Street 1:101 DEERFIELD TRL
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9510
Mailing Address - Country:US
Mailing Address - Phone:919-360-2495
Mailing Address - Fax:
Practice Address - Street 1:101 DEERFIELD TRL
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-9510
Practice Address - Country:US
Practice Address - Phone:919-360-2495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty