Stephanie Rita McDonough, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6023 Issued in NC

Practice address

1515 Mockingbird LN Ste 580
Charlotte, NC 28209-1171

Phone

(704) 910-8381

Fax

(704) 981-8282

NPI assigned

Jul 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Base, PLLC

  • Psychologist
  • Charlotte, NC
  • NPI 1265936108
  NPD (past)

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1215599766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN STE 580",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091171",
            "telephone_number": "704-910-8381",
            "fax_number": "704-981-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN STE 580",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091171",
            "telephone_number": "704-910-8381",
            "fax_number": "704-981-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "STEPHANIE",
        "middle_name": "RITA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-05",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "10525",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "6023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoriyah Amel McDonald
• Colleen McDonnell
• Heather Kathleen McDonnell, BSN, RN, CCM
• Molly McDonnell, MSW, LCSWA
• Michal Levine McDonough, M.ED
• Thalita Maria McDonough
• Keonna McDougald, MAT
• Kiora McDougald
• Cameron Schyler McDowell, NP
• Crystal Leann McDowell, LCMHC

• Psychologist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.