Provider Demographics
NPI:1295829356
Name:CHARTIER, DAN R (PHD)
Entity type:Individual
Prefix:
First Name:DAN
Middle Name:R
Last Name:CHARTIER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 KEISLER DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-7069
Mailing Address - Country:US
Mailing Address - Phone:919-781-9950
Mailing Address - Fax:919-783-9950
Practice Address - Street 1:400 KEISLER DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-7069
Practice Address - Country:US
Practice Address - Phone:919-781-9950
Practice Address - Fax:919-783-9950
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1111103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC03201OtherBCBSNC
NC75527OtherMEDCOST
NC8903201Medicaid
NC2813800BMedicare PIN
NC8903201Medicaid