| Carolina Psych Group, Pa | |
|
515 Brookdale Dr Statesville NC 28677-4107 | |
| (704) 873-1697 | |
| Not Available |
| Full Name | Carolina Psych Group, Pa |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 515 Brookdale Dr, Statesville, North Carolina |
| Authorized Official Name and Position | James A Powell (CEO/CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7048731697 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Psych Group, Pa 515 Brookdale Dr Statesville NC 28677-4107 Ph: (704) 873-1697 | Carolina Psych Group, Pa 515 Brookdale Dr Statesville NC 28677-4107 Ph: (704) 873-1697 |
| NPI Number | 1730131863 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730131863 | NPI | - | NPPES |
| 6005112 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 633 (North Carolina) | Primary |
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