Provider Demographics
NPI:1710061098
Name:ALTSCHUL, ADENA RENE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ADENA
Middle Name:RENE
Last Name:ALTSCHUL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 TRIO LN
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-4507
Mailing Address - Country:US
Mailing Address - Phone:828-974-6154
Mailing Address - Fax:828-639-8251
Practice Address - Street 1:24 ARLINGTON ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2006
Practice Address - Country:US
Practice Address - Phone:828-974-6154
Practice Address - Fax:828-639-8251
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3392103T00000X, 103TC0700X, 103TF0000X, 103TB0200X, 103TC2200X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy