Carolina Neurobehavioral Service

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

4230 Issued in NC

Legal business name

CAROLINA NEUROBEHAVIORAL SERVICE

Practice address

7810 Ballantyne Commons Pkwy
Suite 309
Charlotte, NC 28277-3415

Phone

(704) 319-5538

Fax

(888) 703-9409

NPI assigned

Jul 18, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Lisa Anne Sworowski, PH.D.NPI 1891824306

Title

Owner/Neurpsychologist

Phone

(704) 319-5538

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Anne Sworowski, PH.D.

  • Clinical Neuropsychologist
  • Charlotte, NC
  • NPI 1891824306
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357084800000",
    "number": "1053666834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7810 BALLANTYNE COMMONS PKWY",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773415",
            "telephone_number": "704-319-5538",
            "fax_number": "888-703-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7810 BALLANTYNE COMMONS PKWY",
            "address_2": "SUITE 309",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773415",
            "telephone_number": "704-319-5538",
            "fax_number": "888-703-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA NEUROBEHAVIORAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2013-01-02",
        "status": "A",
        "authorized_official_last_name": "SWOROWSKI",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER/NEURPSYCHOLOGIST",
        "authorized_official_telephone_number": "704-319-5538",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "NC",
            "license": "4230",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4230",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Medicorp Enterprises, Inc
• Carolina Medicorp Enterprises, Inc.
• Carolina Medicorp Enterprises, Inc.
• Carolina Medicorp Enterprises, Inc.
• Carolina Medicorp Enterprises, LLC
• Carolina Neurological Clinic, PA
• Carolina Neuropathy Centers, PLLC
• Carolina Neurosurgery & Spine Associates PA
• Carolina Neurosurgery & Spine Associates, PA
• Carolina Oncology Specialist PA

• All providers in Charlotte, NC
• Clinical Neuropsychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.