Basic Information
| Provider Information | |||||||||
| NPI: | 1245259514 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCALENEY | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 114 HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283055306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104840176 | ||||||||
| FaxNumber: | 9104845781 | ||||||||
| Practice Location | |||||||||
| Address1: | 114 HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283055306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104840176 | ||||||||
| FaxNumber: | 9104845781 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 02/04/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 25370 | TX | N | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TC0700X | 3239 | NC | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 04633 | 01 | NC | BCBS INDIVIDUAL | OTHER | 6000902 | 05 | NC | MEDICAID | 0173P | 01 | NC | BCBS GROUP | OTHER |