Active NPI
Marvin Burt Poston Jr., PSY.D.
- Pastoral Counselor
- Charlotte, NC
National Provider Identifier
1366426819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- Practice address
- 1515 Mockingbird LN
Suite 212
Charlotte, NC 28209-3236 - Phone
- (704) 522-8490
- NPI assigned
- Nov 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | Primary | ||
| Cognitive & Behavioral Psychologist | 103TB0200X | 1746 | NC | |
| Clinical Psychologist | 103TC0700X | 1746 | NC | |
| Counseling Psychologist | 103TC1900X | 1746 | NC | |
| Psychologist | 103T00000X | 1746 | NC |
Addresses
Primary practice location
1515 Mockingbird LN
Suite 212
Charlotte, NC 28209-3236
Mailing address
1226 Estate Ave
No. 2024
Charlotte, NC 28209-0221
Phone (704) 517-4145
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| VARIOUS COMPANIES | Other | PROVIDER NUMBERS | |
| 6000549 | Medicaid | NC | |
| 0362H | Other | NC | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1746 | NC | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parktowne Psychological Services | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Charlotte, NC
- NPI 1336336023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1366426819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1226 ESTATE AVE",
"address_2": "NO. 2024",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282090221",
"telephone_number": "704-517-4145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 MOCKINGBIRD LN",
"address_2": "SUITE 212",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282093236",
"telephone_number": "704-522-8490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POSTON",
"first_name": "MARVIN",
"middle_name": "BURT",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-29",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": null,
"license": null,
"primary": true
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NC",
"license": "1746",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "1746",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NC",
"license": "1746",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "1746",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER NUMBERS",
"identifier": "VARIOUS COMPANIES",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000549",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0362H",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.