Provider Demographics
NPI:1184943003
Name:WANG, MEI-CHUAN (PHD)
Entity type:Individual
Prefix:DR
First Name:MEI-CHUAN
Middle Name:
Last Name:WANG
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 1:596 EXECUTIVE PL STE 102
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5189
Mailing Address - Country:US
Mailing Address - Phone:910-758-1799
Mailing Address - Fax:910-781-8700
Practice Address - Street 1:596 EXECUTIVE PL STE 102
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5189
Practice Address - Country:US
Practice Address - Phone:910-758-1799
Practice Address - Fax:910-781-8700
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2022-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
NC4352103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104526Medicaid
472557OtherMHN