| Carolina Psychiatry, P.c. | |
|
548 Sandhurst Dr Fayetteville NC 28304-4426 | |
| (910) 484-3400 | |
| (910) 484-3404 |
| Full Name | Carolina Psychiatry, P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 548 Sandhurst Dr, Fayetteville, North Carolina |
| Authorized Official Name and Position | Shabbir Ahmed Chowdhury (OWNER) |
| Authorized Official Contact | 9104843400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Psychiatry, P.c. 548 Sandhurst Dr Fayetteville NC 28304-4426 Ph: (910) 484-3400 | Carolina Psychiatry, P.c. 548 Sandhurst Dr Fayetteville NC 28304-4426 Ph: (910) 484-3400 |
| NPI Number | 1114116944 |
|---|---|
| Provider Enumeration Date | 10/17/2007 |
| Last Update Date | 07/30/2020 |
| Certification Date | 07/30/2020 |
| Medicare PECOS PAC ID | 5991894180 |
|---|---|
| Medicare Enrollment ID | O20071211000739 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114116944 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 200401185 (North Carolina) | Primary |
| Provider Name | Shabbir A Chowdhury |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760486617 PECOS PAC ID: 7810966876 Enrollment ID: I20041103001253 |
| Provider Name | Mizanur Rahman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356376156 PECOS PAC ID: 0547386856 Enrollment ID: I20100923001211 |
| Provider Name | Ashley G Clocher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891121372 PECOS PAC ID: 3173833902 Enrollment ID: I20151107000128 |
| Provider Name | Bianco Holmon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215331590 PECOS PAC ID: 6800144452 Enrollment ID: I20180730003160 |
| Provider Name | Wakeelah T Gilmore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992041974 PECOS PAC ID: 7618380197 Enrollment ID: I20201229002351 |
| Provider Name | Cassandra L Burney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285281451 PECOS PAC ID: 2961896543 Enrollment ID: I20220224000961 |
| Provider Name | Alyssa J Melone |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528661402 PECOS PAC ID: 3779951744 Enrollment ID: I20221122003029 |
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