Provider Demographics
NPI:1831153899
Name:DEBORAH A ATKINSON PHD PA
Entity type:Organization
Organization Name:DEBORAH A ATKINSON PHD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHD PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:910-429-0003
Mailing Address - Street 1:592 EXECUTIVE PLACE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305
Mailing Address - Country:US
Mailing Address - Phone:910-429-0003
Mailing Address - Fax:910-323-1921
Practice Address - Street 1:592 EXECUTIVE PLACE
Practice Address - Street 2:SUITE 101
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305
Practice Address - Country:US
Practice Address - Phone:910-429-0003
Practice Address - Fax:910-323-1921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2325103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty