Provider Demographics
NPI:1902231525
Name:Q1 CLINICAL CONSULTANTS,LLC
Entity Type:Organization
Organization Name:Q1 CLINICAL CONSULTANTS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MATISHA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:919-303-5377
Mailing Address - Street 1:1011 W WILLIAMS ST
Mailing Address - Street 2:STE 102
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-3979
Mailing Address - Country:US
Mailing Address - Phone:919-303-5377
Mailing Address - Fax:919-303-5380
Practice Address - Street 1:1220 ROBINSON AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-3334
Practice Address - Country:US
Practice Address - Phone:919-303-5377
Practice Address - Fax:919-303-5377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408501Medicaid