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Contact Information

CARDINAL CLINIC LLC
1540 PURDUE DR STE 200
FAYETTEVILLE, NC28303-5510
 Phone: 910-867-8889
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Counselor

101Y00000X
 

Mental Health

101YM0800X
 

Professional

101YP2500X
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for CARDINAL CLINIC LLC

NPI Number 1982761250
LBN Legal business name CARDINAL CLINIC LLC
Authorized official TONY GARCIA - (QM COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/03/2007
Last updated 05/20/2009 - About 17 years ago
Identifiers
NC Medicaid 8300391
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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