MARY MEREDITH GILLIS (NPI# 1245630854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245630854 |
Entity Type | Individual |
Full Name | MARY MEREDITH GILLIS |
Credential | PH.D. |
Practice Address |
1918 Randolph Rd Suite 400 Charlotte NC 28207-1100 |
Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
Practice Telephone | 7043849437 |
Mailing Telephone | 7043849437 |
Enumeration Date | 2014-09-02 |
Last Update Date | 2020-10-28 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103T00000X | Psychologist | 4667 | NC | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548485642 | Mary Vaste Gillis | Marriage & Family Therapist | 115 Liberty St Ste 1, Petaluma, CA 94952-2320 | 2007-04-16 |
1285082925 | Mary Alyssa Gillis | Nurse Practitioner | 56 Dutch Ln, Columbus, MS 39702-5500 | 2016-06-02 |
1750764130 | Mary Katherine Gillis | Psychologist | 2035 Hogback Rd, Suite 207, Ann Arbor, MI 48105-9732 | 2015-07-03 |
Street Address |
1918 RANDOLPH RD SUITE 400 |
City | CHARLOTTE |
State | NC |
Zip Code | 28207-1100 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588660625 | Christopher John Danner | Specialist | 1918 Randolph Rd, Ste. 300, Charlotte, NC 28207-1100 | 2005-06-23 |
1942745807 | Novant Medical Group, Inc | Psychiatry & Neurology | 1918 Randolph Rd, Suite 400, Charlotte, NC 28207-1100 | 2017-01-03 |
1659727881 | Katherine Mcclure | Physician Assistant | 1918 Randolph Rd, Suite 400, Charlotte, NC 28207-1100 | 2016-05-06 |
1467810531 | Kristina Hendley Sapel | Physician Assistant | 1918 Randolph Rd, Suite 550, Charlotte, NC 28207-1100 | 2016-02-04 |
1376910877 | Elaine Mejia | Physician Assistant | 1918 Randolph Rd, Suite 220, Charlotte, NC 28207-1100 | 2015-09-01 |
1437552114 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1918 Randolph Rd, Suite 275-a, Charlotte, NC 28207-1100 | 2014-10-08 |
1093136939 | Amy Vischetti Moore | Physician Assistant | 1918 Randolph Rd, Ste. 580, Charlotte, NC 28207-1100 | 2013-12-19 |
1962831651 | Candice Halle Kessler | Nurse Practitioner | 1918 Randolph Rd, Suite 670, Charlotte, NC 28207-1100 | 2013-11-04 |
1184059958 | Alicja Erazo Sundblade | Registered Nurse | 1918 Randolph Rd, Suite 350, Charlotte, NC 28207-1100 | 2013-09-11 |
1710228077 | Novant Medical Group Inc | Obstetrics & Gynecology | 1918 Randolph Rd, Suite 300, Charlotte, NC 28207-1100 | 2013-03-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
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Taxonomy Code | 103T00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
Notes: Source: American Psychological Association [1/1/2007: modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720698939 | Blue Ridge Behavior Systems Inc | Psychologist | 16147 Lancaster Hwy Ste 110, Charlotte, NC 28277-4196 | 2020-08-03 |
1689297921 | David B Spano | Psychologist | 3205 N Mcdowell St, Charlotte, NC 28205-1552 | 2020-05-21 |
1447721055 | Alexis Brightman, Pllc | Psychologist | 1914 J N Pease Pl Ste 172, Charlotte, NC 28262-4504 | 2018-12-07 |
1366920712 | Robbie Mae & Associates, LLC | Psychologist | 4020 Lakota Ct, Charlotte, NC 28269-4074 | 2018-07-29 |
1295222347 | Kathleen Lucey Hack | Psychologist | 9617 Runswyck Ct, Charlotte, NC 28269-8393 | 2018-04-15 |
1285133405 | Jill Pratt | Psychologist | 447 S Sharon Amity Rd Ste 140, Charlotte, NC 28211-2888 | 2018-02-02 |
1467847426 | Marguerita Sitrin Blaker | Psychologist | 2400 Crownpoint Executive Drive, Suite 100, Office #5, Charlotte, NC 28227 | 2015-04-06 |
1699193672 | Elizabeth Ann Peterson-vita | Psychologist | 700 East Stonewall Street, Suite 714, Charlotte, NC 28202 | 2014-04-07 |
1093137093 | Epiphany Integrated Care Services, LLC | Psychologist | 4921 Albemarle Rd, Suite 203, Charlotte, NC 28205-6654 | 2014-01-09 |
1568891588 | Terrence Schofield | Psychologist | 6060 Piedmont Row Dr S Ste 120, Charlotte, NC 28287-2801 | 2013-11-12 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.