Wagaman, George Lane
Wagaman, George Lane is an sole proprietor health care provider with primary practice located at 100 Europa Dr , Chapel Hill NC 27517-2357. He recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Health Service. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Wagaman, George Lane can be contacted via phone (919) 929-1227.Contact Information
Primary practice address
100 Europa Dr
Chapel Hill NC 27517-2357
Phone: (919) 929-1227
Fax: (919) 968-2575
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | 182 | West Virginia |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 182 | West Virginia |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 182 | West Virginia |
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | 182 | West Virginia |
| Behavioral Health & Social Service Providers / Forensic | 103TF0200X | 182 | West Virginia |
| Behavioral Health & Social Service Providers / Health Service | 103TH0100X | 182 | West Virginia |
Profile Details
| NPI number | 1699854042 |
|---|---|
| LBN Legal business name | Wagaman, George Lane |
| Credentials | ED.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 6th, 2006 |
| Last updated | Mar 1st, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699854042 | NPPES |
| West Virginia | MEDICAID | 9205024000 | |
| West Virginia | Other | 001712519 |
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