Kids Can, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1130 Issued in NC

Legal business name

KIDS CAN, LLC

Practice address

233 S Sharon Amity Rd
Suite 103
Charlotte, NC 28211-2880

Phone

(704) 364-4133

Fax

(704) 364-4134

NPI assigned

Jan 2, 2009

Last updated

Jan 2, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Daphne Timmons, PH.D

Title

Psychologist/Manager of Corporation

Phone

(704) 364-4133

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1230854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230854400000",
    "number": "1326284910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 S. SHARON-AMITY ROAD",
            "address_2": "SUITE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112880",
            "telephone_number": "704-364-4133",
            "fax_number": "704-364-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 S SHARON AMITY RD",
            "address_2": "SUITE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112880",
            "telephone_number": "704-364-4133",
            "fax_number": "704-364-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS CAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-02",
        "last_updated": "2009-01-02",
        "status": "A",
        "authorized_official_last_name": "TIMMONS",
        "authorized_official_first_name": "DAPHNE",
        "authorized_official_title_or_position": "PSYCHOLOGIST/MANAGER OF CORPORATION",
        "authorized_official_telephone_number": "704-364-4133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "3216",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "1130",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C001983",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103892",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000262",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 Jan 2, 2009; 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.