Charlotte Psychological Assessment II PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3520 Issued in NC

Legal business name

CHARLOTTE PSYCHOLOGICAL ASSESSMENT II PA

Practice address

3303 Latrobe Dr
Charlotte, NC 28211-4851

Phone

(704) 362-2663

Fax

(704) 362-2836

NPI assigned

Jun 29, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Nicole Lacoste Cantley, PH.D.NPI 1558533968

Title

President/Psychologist

Phone

(704) 841-1163

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.

• Nicole Lacoste Cantley, PH.D.

  • Clinical Psychologist
  • Charlotte, NC
  • NPI 1558533968
  NPD (past) Authorized official

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1306157888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 SARDIS RD N",
            "address_2": "SUITE 207",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282701426",
            "telephone_number": "704-841-1163",
            "fax_number": "704-841-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 LATROBE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114851",
            "telephone_number": "704-362-2663",
            "fax_number": "704-362-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE PSYCHOLOGICAL ASSESSMENT II PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-29",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "CANTLEY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "LACOSTE",
        "authorized_official_title_or_position": "PRESIDENT/PSYCHOLOGIST",
        "authorized_official_telephone_number": "704-841-1163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.