NPIMap

Organization Active NPI

Porters Neck Psychological Services, PLLC

  • Psychologist
  • Wilmington, NC
National Provider Identifier
1265750681
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3488 Issued in NC
Legal business name
PORTERS NECK PSYCHOLOGICAL SERVICES, PLLC
Practice address
8044 Market St Unit D
Wilmington, NC 28411-9384
Phone
(910) 686-3505
Fax
(910) 821-5116
NPI assigned
May 10, 2010
Last updated
May 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Authorized official

Name
Sonya Seguin, LCMHCNPI 1700270220
Title
Manager
Phone
(910) 686-3505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3488 NC Primary

Addresses

Primary practice location

8044 Market St Unit D
Wilmington, NC 28411-9384

Mailing address

8044 Market St Unit D
Wilmington, NC 28411-9384
Phone (910) 686-3505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101116000700 NC Part B Supplier - Clinic/Group Practice 9931394996 Receives reassigned benefits from 6 practitioners
Practice locations: Wilmington, NC

National Provider Directory

National Provider Directory

Locations

8044 Market St
#D
Wilmington, NC 28411
Phone (910) 686-3505

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1265750681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8044 MARKET ST UNIT D",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119384",
            "telephone_number": "910-686-3505",
            "fax_number": "910-821-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8044 MARKET ST UNIT D",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119384",
            "telephone_number": "910-686-3505",
            "fax_number": "910-821-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERS NECK PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-10",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "SEGUIN",
        "authorized_official_first_name": "SONYA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "910-686-3505",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.