Provider Demographics
NPI:1982858023
Name:HARTLEY, JAMES RHETT
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RHETT
Last Name:HARTLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 PAXTON PL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-1341
Mailing Address - Country:US
Mailing Address - Phone:919-800-1446
Mailing Address - Fax:919-575-1282
Practice Address - Street 1:3101 PAXTON PL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1341
Practice Address - Country:US
Practice Address - Phone:919-800-1446
Practice Address - Fax:919-575-1282
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1570103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral