Active NPI
Jane L Marcus, PSY. D.
- Clinical Psychologist
- Charlotte, NC
National Provider Identifier
1114906146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1645
- Practice address
- 6831 Fairview Rd Ste a
Charlotte, NC 28210-0125 - Phone
- (704) 364-2151
- Fax
- (704) 366-6828
- NPI assigned
- Jan 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1645 | NC | Primary |
Addresses
Primary practice location
6831 Fairview Rd Ste a
Charlotte, NC 28210-0125
Mailing address
7319 Valleybrook Rd
Charlotte, NC 28270-6546
Phone (704) 364-2151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1645 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233187200000",
"number": "1114906146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7319 VALLEYBROOK RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282706546",
"telephone_number": "704-364-2151",
"fax_number": "704-366-6828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6831 FAIRVIEW RD STE A",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282100125",
"telephone_number": "704-364-2151",
"fax_number": "704-366-6828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCUS",
"first_name": "JANE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PSY. D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-09",
"last_updated": "2009-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "1645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.