Provider Demographics
NPI:1457560310
Name:GARNES, DELBERT FRANKLIN (PHD)
Entity type:Individual
Prefix:
First Name:DELBERT
Middle Name:FRANKLIN
Last Name:GARNES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 BETTY DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-7936
Mailing Address - Country:US
Mailing Address - Phone:252-335-3340
Mailing Address - Fax:
Practice Address - Street 1:400 BETTY DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-7936
Practice Address - Country:US
Practice Address - Phone:252-335-3340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2746103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC60000505Medicaid