Provider Demographics
NPI:1770140485
Name:SMOKY MOUNTAIN PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:SMOKY MOUNTAIN PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:C
Authorized Official - Last Name:TURPIN
Authorized Official - Suffix:III
Authorized Official - Credentials:PSYD
Authorized Official - Phone:828-226-2352
Mailing Address - Street 1:52 WALNUT ST STE 4
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-7402
Mailing Address - Country:US
Mailing Address - Phone:828-226-2352
Mailing Address - Fax:
Practice Address - Street 1:52 WALNUT ST STE 4
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-7402
Practice Address - Country:US
Practice Address - Phone:828-226-2352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1417006230OtherNPI