MARY MEREDITH GILLIS


Address: 1918 Randolph Rd, Suite 400, Charlotte, NC 28207-1100
Phone: 7043849437

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist 4667 NC Behavioral Health & Social Service Providers

Other Providers MARY GILLIS

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

Office Location

Street Address 1918 RANDOLPH RD
SUITE 400
City CHARLOTTE
State NC
Zip Code 28207-1100

Providers in the same location

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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Providers in the same zip code

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 Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

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]

Providers in the same taxonomy and city

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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Competitor

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City CHARLOTTE
Zip Code 28207

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Dataset Information

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.

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