Provider Demographics
NPI:1891445813
Name:IWE FAMILY PSYCHOLOGY INC
Entity Type:Organization
Organization Name:IWE FAMILY PSYCHOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NANDANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SURANA
Authorized Official - Suffix:
Authorized Official - Credentials:LPA
Authorized Official - Phone:404-312-6863
Mailing Address - Street 1:439 SHALE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6562
Mailing Address - Country:US
Mailing Address - Phone:404-312-6863
Mailing Address - Fax:
Practice Address - Street 1:189 WIND CHIME CT STE 202
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6480
Practice Address - Country:US
Practice Address - Phone:919-200-0224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)