NPIMap

Organization Active NPI

Psychotherapeutic Services

  • Group Psychotherapy Psychologist
  • Burlington, NC
National Provider Identifier
1023179579
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
License
231369010 Issued in NC
Legal business name
PSYCHOTHERAPEUTIC SERVICES
Practice address
2260 S. Church St
Suite 303
Burlington, NC 27215
Phone
(336) 538-6990
Fax
(336) 538-6691
NPI assigned
Dec 12, 2006
Last updated
Oct 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marcia Lynn Clendaniel
Title
Billing Manager
Phone
(410) 810-2465

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist 103TP2701X 231369010 NC Primary

Addresses

Primary practice location

2260 S. Church St
Suite 303
Burlington, NC 27215

Mailing address

2260 S Church St
Suite 303
Burlington, NC 27215
Phone (410) 778-9114

National Provider Directory

National Provider Directory
Tax ID family
Psi Acist Program44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1023179579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 S CHURCH ST",
            "address_2": "SUITE 303",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "27215",
            "telephone_number": "410-778-9114",
            "fax_number": "470-778-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 S. CHURCH ST",
            "address_2": "SUITE 303",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "27215",
            "telephone_number": "336-538-6990",
            "fax_number": "336-538-6691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOTHERAPEUTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "CLENDANIEL",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "410-810-2465"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NC",
            "license": "231369010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.