North Carolina Psych Services PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

NORTH CAROLINA PSYCH SERVICES PLLC

Practice address

3771 Ramsey St Ste 109-140
Fayetteville, NC 28311-7675

Phone

(330) 536-3746

Fax

(330) 267-4250

NPI assigned

Jul 14, 2021

Last updated

Aug 24, 2021By 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

Robert Rae, MD

Title

Ceo

Phone

(330) 536-3746

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Interoperability endpoints

• Direct secure messaging: credentialing@psych360.org

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1356913842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3593 MEDINA RD # 181",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568182",
            "telephone_number": "330-536-3746",
            "fax_number": "330-267-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3771 RAMSEY ST STE 109-140",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283117675",
            "telephone_number": "330-536-3746",
            "fax_number": "330-267-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA PSYCH SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "RAE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-536-3746",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CREDENTIALING@PSYCH360.ORG",
            "affiliation": "N",
            "endpointDescription": "CREDENTIALING@PSYCH360.ORG",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3771 Ramsey St Ste 109-140",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283117675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.