| Classical Psychotherapy Pc | |
|
421 Fayetteville St Suite 1100 Raleigh NC 27601 | |
| (919) 825-0388 | |
| Not Available |
| Full Name | Classical Psychotherapy Pc |
|---|---|
| Speciality | Social Worker |
| Location | 421 Fayetteville St, Raleigh, North Carolina |
| Authorized Official Name and Position | Mariam Elshenawy (PRESIDENT) |
| Authorized Official Contact | 9198250388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Classical Psychotherapy Pc 421 Fayetteville St Suite 1100 Raleigh NC 27601 Ph: (919) 825-0388 | Classical Psychotherapy Pc 421 Fayetteville St Suite 1100 Raleigh NC 27601 Ph: (919) 825-0388 |
| NPI Number | 1700542479 |
|---|---|
| Provider Enumeration Date | 11/16/2021 |
| Last Update Date | 11/06/2024 |
| Medicare PECOS PAC ID | 2466987813 |
|---|---|
| Medicare Enrollment ID | O20241122001197 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700542479 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mariam Elshenawy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437621703 PECOS PAC ID: 5193250546 Enrollment ID: I20250218001263 |
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