Community Psychological Resources, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1663 Issued in NC

Legal business name

COMMUNITY PSYCHOLOGICAL RESOURCES, LLC

Practice address

5749 Ruth Dr
Charlotte, NC 28215-2231

Phone

(704) 763-0687

NPI assigned

Nov 5, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey Tonkins Marshall, LPANPI 1346373750

Title

Psychologist/Owner

Phone

(704) 763-0687

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jeffrey Tonkins Marshall, MA

  • Psychologist
  • Charlotte, NC
  • NPI 1346373750
  NPD (past) Authorized official

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1124329271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5749 RUTH DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282152231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5749 RUTH DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282152231",
            "telephone_number": "704-763-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PSYCHOLOGICAL RESOURCES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "TONKINS",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "704-763-0687",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "1663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.