| Prism Psychological Services, Pc | |
|
19810 W Catawba Ave Ste E Cornelius NC 28031-4057 | |
| (704) 212-2020 | |
| (704) 212-2020 |
| Full Name | Prism Psychological Services, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 19810 W Catawba Ave Ste E, Cornelius, North Carolina |
| Authorized Official Name and Position | Ronald Field (PRESIDENT) |
| Authorized Official Contact | 7042122020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prism Psychological Services, Pc 19810 W Catawba Ave Ste E Cornelius NC 28031-4057 Ph: (704) 212-2020 | Prism Psychological Services, Pc 19810 W Catawba Ave Ste E Cornelius NC 28031-4057 Ph: (704) 212-2020 |
| NPI Number | 1144747452 |
|---|---|
| Provider Enumeration Date | 08/28/2017 |
| Last Update Date | 10/04/2018 |
| Medicare PECOS PAC ID | 2769758341 |
|---|---|
| Medicare Enrollment ID | O20171026000775 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144747452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 4903 (North Carolina) | Primary |
| Provider Name | Ronald S Field |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952416083 PECOS PAC ID: 2567563240 Enrollment ID: I20171026000916 |
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