Brandyberry, Lisa Jeanne

Brandyberry, Lisa Jeanne is an individual health care provider with primary practice located at 284 Executive Park Dr Suite 100, Concord NC 28025-1831. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Brandyberry, Lisa Jeanne can be contacted via phone (704) 939-1100.

Contact Information

Primary practice address
284 Executive Park Dr Suite 100 Concord NC 28025-1831
Phone: (704) 939-1100
Fax: (704) 939-1173
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1842 North Carolina

Profile Details

NPI number 1760499156
LBN Legal business name Brandyberry, Lisa Jeanne
Credentials PHD.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Sep 6th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760499156 NPPES
North Carolina MEDICAID 6000631

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