Psyclinc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

4642 Issued in NC

Legal business name

PSYCLINC

Practice address

518 S Aspen St
Lincolnton, NC 28092-2735

Phone

(704) 530-0850

NPI assigned

Aug 19, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Mary Rachel Rebecca Reavis, PHDNPI 1659320265

Title

Psychologist

Phone

(704) 530-0850

Specialties & licenses 1

Addresses

Tax ID family

Psyclinc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Psyclinc

  • Clinical Psychologist
  • Lincolnton, NC
  • NPI 1356517536
  NPD tax ID

Practitioners 1

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

• Mary R Reavis, PH.D.

  • Clinical Psychologist
  • Lincolnton, NC
  • NPI 1659320265
  NPD (past) Authorized official

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1235538901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 S ASPEN ST",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280922735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 S ASPEN ST",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280922735",
            "telephone_number": "704-530-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCLINC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "REAVIS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "RACHEL REBECCA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "704-530-0850",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "4642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trace Pigg, PHARMD
• Jenesia Renee Pope, BT
• Stephanie Ann Porter, PHD, LPCS, CCS, MAC
• Allison Marie Prinz, MD
• Prowellness Family Chiropractic Inc
• Psyclinc
• Lavanya Sireesha Putchala, DDS
• R Keith Dedmond DDS PA
• R. Gary Hensley, D.M.D., P.a.
• Toma Radut, MD

• Community/Behavioral Health Agency in Lincolnton, NC
• Providers in Lincolnton, 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 Aug 19, 2014; 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.