Provider Demographics
NPI:1609691930
Name:TRAUMA RECOVERY COLLECTIVE, PLLC
Entity type:Organization
Organization Name:TRAUMA RECOVERY COLLECTIVE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LCMHCS NCC CCTP
Authorized Official - Phone:919-791-7545
Mailing Address - Street 1:1551 ATRIA CIR APT 2122
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-5330
Mailing Address - Country:US
Mailing Address - Phone:919-791-7545
Mailing Address - Fax:
Practice Address - Street 1:1551 ATRIA CIR APT 2122
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-5330
Practice Address - Country:US
Practice Address - Phone:919-791-7545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)