Provider Demographics
NPI:1841552866
Name:TELEPSYCH SUPPORTS PLLC
Entity type:Organization
Organization Name:TELEPSYCH SUPPORTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:VERGOLIAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:919-523-8817
Mailing Address - Street 1:6500 CREEDMOOR RD STE 106
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-3698
Mailing Address - Country:US
Mailing Address - Phone:919-523-8817
Mailing Address - Fax:888-523-6763
Practice Address - Street 1:6500 CREEDMOOR RD STE 106
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-3698
Practice Address - Country:US
Practice Address - Phone:919-523-8817
Practice Address - Fax:888-523-6763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health