Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Other names
Psychiatry, Lakeview Child & Family
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER T FREDERICK (CFO)
(919) 620-4918
Entity
Organization
Contact information
Practice address
2608 ERWIN RD, STE 300, DURHAM, NC 27705-4596
(919) 681-1100
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
10/12/2016
Last updated
05/18/2022
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