Provider Demographics
NPI:1689887408
Name:BRASSELL, WILLIAM REED JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:REED
Last Name:BRASSELL
Suffix:JR
Gender:M
Credentials:PHD
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Mailing Address - Street 1:226 MORGANTON BLVD SW
Mailing Address - Street 2:SUITE I
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5225
Mailing Address - Country:US
Mailing Address - Phone:828-757-3839
Mailing Address - Fax:828-757-3839
Practice Address - Street 1:226 MORGANTON BLVD SW
Practice Address - Street 2:SUITE I
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5225
Practice Address - Country:US
Practice Address - Phone:828-757-3839
Practice Address - Fax:828-757-3839
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0398103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC4531OtherMEDCOST
NC6115453OtherUNITED BEHAVIORAL HEALTH
NC0315FOtherBCBS OF NORTH CAROLINA
NC5644172OtherAETNA
NC6115453OtherUNITED BEHAVIORAL HEALTH