PSYCHOLOGICAL SERVICES OF CHARLOTTE (NPI# 1295768943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295768943 |
| Entity Type | Organization |
| Organization Name | PSYCHOLOGICAL SERVICES OF CHARLOTTE |
| Practice Address |
1923 J N Pease Pl Suite 204 Charlotte NC 28262-4513 |
| Practice Telephone | 7045033535 |
| Practice Fax Number | 7045935555 |
| Mailing Telephone | 7045033535 |
| Mailing Fax Number | 7045935555 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-05-15 |
| Authorized Official Name | MR. BRIAN RONALD MONTELEONE (PRESIDENT) |
| Authorized Official Telephone | 7045033535 |
| Authorized Official Credential | PH. D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 3953 | NC | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
C004544 | NC | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | 3660 | NC | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | 4444 | NC | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
3328NCLPC | NC | Behavioral Health & Social Service Providers |
| Y | 103T00000X | Psychologist | 2846 | NC | Behavioral Health & Social Service Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
12226 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | AETNA | 7496772 | 01 |
| NC | BCBS | 017TA | 01 |
| Street Address |
1923 J N PEASE PL SUITE 204 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28262-4513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447869763 | Glacia Ethridge | Counselor | 1923 J N Pease Pl, Charlotte, NC 28262-4513 | 2020-07-23 |
| 1588205124 | Aspire Life Services, Pllc | Counselor | 1923 J N Pease Pl, Charlotte, NC 28262-4513 | 2019-10-04 |
| 1083000202 | Emily Jeffries | Counselor | 1923 J N Pease Pl, Suite 104, Charlotte, NC 28262-4513 | 2015-04-14 |
| 1831510965 | Rachel Stout | Counselor | 1923 J N Pease Pl, Ste 104, Charlotte, NC 28262-4513 | 2013-12-16 |
| 1124371372 | Healing Solutions Counseling Center, Pllc | Counselor | 1923 J N Pease Pl, Suite 104, Charlotte, NC 28262-4513 | 2012-10-24 |
| 1659628030 | Gene Randolph Edwards | Psychologist | 1923 J N Pease Pl, Suite 204, Charlotte, NC 28262-4513 | 2012-08-05 |
| 1417185380 | Kristin M Grasso | Psychologist | 1923 J N Pease Pl, Suite 204, Charlotte, NC 28262-4513 | 2009-06-30 |
| 1275780892 | Kimberly Marie Coons | Marriage & Family Therapist | 1923 J N Pease Pl, Suite 104, Charlotte, NC 28262-4513 | 2008-08-26 |
| 1528250164 | Sarah Millman Carley | Counselor | 1923 J N Pease Pl, Suite 204, Charlotte, NC 28262-4513 | 2007-08-17 |
| 1730397191 | Matthew S. Burgess Leary | Psychologist | 1923 J N Pease Pl, Suite 204, Charlotte, NC 28262-4513 | 2007-05-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056913 | Aleta Michelle Johnson | Specialist | 9711 David Taylor Dr., Ste. 145, Charlotte, NC 28262 | 2020-09-01 |
| 1275161580 | Londyn Homecare Agency L.l.c | Home Health | 1914j.n. Place, Charlotte, NC 28262 | 2020-03-31 |
| 1154964914 | Abundant Love Home Care Service LLC | In Home Supportive Care | 1981 J.n. Pease Place, Ste 204, Charlotte, NC 28262 | 2019-10-24 |
| 1104399070 | Nattya S Pilgreen | Prosthetist | 410 E Mccullough Drive, Suite 103, Charlotte, NC 28262 | 2019-01-03 |
| 1114404506 | Laura Ida Anthony-getant | Social Worker | 10130 Mallard Creek Road, Ste 300 #333, Charlotte, NC 28262 | 2018-07-27 |
| 1720573587 | Carolinas Center for Ambulatory Dentistry LLC | Dentist | 8415 Medical Plaza Drice, Charlotte, NC 28262 | 2018-06-25 |
| 1598254799 | Cassandra Faye Harding | Nurse Practitioner | 1905 Jn Pease Place Suite 103, Charlotte, NC 28262 | 2018-05-03 |
| 1669960746 | Michael Riley | In Home Supportive Care | 8301 University Exec Park Dr Ste 120, Charlotte, NC 28262 | 2018-04-25 |
| 1568989804 | Bridget Coomber | Behavior Technician | 8420 University Executive Dr Ste 810, Charlotte, NC 28262 | 2017-08-28 |
| 1073037701 | Toshana Daley | Physical Therapist | 8801 Jm Keynes Blvd, Charlotte, NC 28262 | 2017-08-03 |
| Find all providers in zip 28262 | ||||
| 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 |
| Find all providers in CHARLOTTE | ||||
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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.