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6115 Park South Dr Ste 135 Charlotte NC 28210-3269 | |
| (704) 562-8717 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 6115 Park South Dr Ste 135, Charlotte, North Carolina |
| Authorized Official Name and Position | Stacie L Macarthur (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 7043644002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
6424 Cameron Forest Ln Apt 1b Charlotte NC 28210-5055 Ph: (704) 562-8717 | 6115 Park South Dr Ste 135 Charlotte NC 28210-3269 Ph: (704) 562-8717 |
| NPI Number | 1942905575 |
|---|---|
| Provider Enumeration Date | 04/03/2023 |
| Last Update Date | 08/06/2024 |
| Certification Date | 08/06/2024 |
| Medicare PECOS PAC ID | 7012448947 |
|---|---|
| Medicare Enrollment ID | O20241003000313 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942905575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Colleen Baldrige |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619464906 PECOS PAC ID: 0143576900 Enrollment ID: I20180709002871 |
| Provider Name | Charles Hampton Hinkle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174654594 PECOS PAC ID: 2961847389 Enrollment ID: I20240226001430 |
| Provider Name | Stacie L. Macarthur |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164574182 PECOS PAC ID: 8628509189 Enrollment ID: I20241009000080 |
| Provider Name | Anna Motta |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982118303 PECOS PAC ID: 6507391737 Enrollment ID: I20241126000210 |
Barbara Kaplan Mhdl Incorporated Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 East Woodlawn Road, Suite 136, Charlotte, NC 28217 Phone: 704-527-2108 Fax: 704-527-2108 | |
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Monarch Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1211 Robinhood Cir, Charlotte, NC 28227 Phone: 704-563-8894 | |
Primary Care Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5601 Executive Center Dr Ste 200, Charlotte, NC 28212 Phone: 704-537-1022 Fax: 704-569-0822 | |
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