NPIMap

Organization Active NPI

Psychological Services of Cindy C. Cottle, PLLC

  • Psychologist
  • Raleigh, NC
National Provider Identifier
1205216181
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3061 Issued in NC
Legal business name
PSYCHOLOGICAL SERVICES OF CINDY C. COTTLE, PLLC
Practice address
4505 Fair Meadows LN
Ste 106
Raleigh, NC 27607-6465
Phone
(919) 301-8513
Fax
(919) 882-1685
NPI assigned
Jun 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Authorized official

Name
Cindy C Cottle, PHD
Title
Psychologist
Phone
(919) 301-8513

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 3061 NC Primary
Forensic PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TF0200X 3061 NC

Addresses

Primary practice location

4505 Fair Meadows LN
Ste 106
Raleigh, NC 27607-6465

Mailing address

4505 Fair Meadows LN
Ste 106
Raleigh, NC 27607-6465
Phone (919) 301-8513

National Provider Directory

National Provider Directory

Locations

4505 Fair Meadows Ln
Ste 106
Raleigh, NC 27607
Phone (919) 301-8513

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1205216181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 FAIR MEADOWS LN",
            "address_2": "STE 106",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076465",
            "telephone_number": "919-301-8513",
            "fax_number": "919-882-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 FAIR MEADOWS LN",
            "address_2": "STE 106",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076465",
            "telephone_number": "919-301-8513",
            "fax_number": "919-882-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL SERVICES OF CINDY C. COTTLE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "COTTLE",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "919-301-8513",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3061",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Forensic",
            "state": "NC",
            "license": "3061",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; 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.