Provider Demographics
NPI:1871507038
Name:THE PISGAH INSTITUTE FOR PSYCHOTHERAPY & EDUCATION, P.A.
Entity Type:Organization
Organization Name:THE PISGAH INSTITUTE FOR PSYCHOTHERAPY & EDUCATION, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:828-254-9494
Mailing Address - Street 1:158 ZILLICOA ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1079
Mailing Address - Country:US
Mailing Address - Phone:828-254-9494
Mailing Address - Fax:828-250-0890
Practice Address - Street 1:158 ZILLICOA ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1079
Practice Address - Country:US
Practice Address - Phone:828-254-9494
Practice Address - Fax:828-250-0890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
NC0143103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0242KOtherBLUE CROSS BLUE SHIELD
NC6005476Medicaid
NC6005476Medicaid