| Southeast Psychological Services, Pllc | |
|
6060 Piedmont Row Dr S Suite 120 Charlotte NC 28287-3884 | |
| (704) 552-0116 | |
| (704) 552-7550 |
| Full Name | Southeast Psychological Services, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 6060 Piedmont Row Dr S, Charlotte, North Carolina |
| Authorized Official Name and Position | Frank W Gaskill (MANAGING PARTNER) |
| Authorized Official Contact | 7045520116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Psychological Services, Pllc 6060 Piedmont Row Dr S Suite 120 Charlotte NC 28287-3884 Ph: (704) 552-0116 | Southeast Psychological Services, Pllc 6060 Piedmont Row Dr S Suite 120 Charlotte NC 28287-3884 Ph: (704) 552-0116 |
| NPI Number | 1811053218 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 11/25/2014 |
| Medicare PECOS PAC ID | 5597735985 |
|---|---|
| Medicare Enrollment ID | O20040731000305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811053218 | NPI | - | NPPES |
| 6005111 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | CO5021 (North Carolina) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Barrie E Morganstein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699859678 PECOS PAC ID: 1153388251 Enrollment ID: I20041209001084 |
| Provider Name | Marie Lewis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336786680 PECOS PAC ID: 9335668623 Enrollment ID: I20250529002647 |
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