Active NPI
Richard Glenn Tedeschi, PH.D.
- Clinical Psychologist
- Concord, NC
National Provider Identifier
1386709350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 605
- Practice address
- 236 Lephillip CT
Suite D
Concord, NC 28025-1917 - Phone
- (704) 342-1812
- Fax
- (704) 342-1884
- NPI assigned
- Dec 27, 2006
- Last updated
- Aug 6, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 605 | NC | Primary |
Addresses
Primary practice location
236 Lephillip CT
Suite D
Concord, NC 28025-1917
Mailing address
PO Box 1351
Concord, NC 28026-1351
Phone (704) 614-1565
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120208000485 | NC | Practitioner - Clinical Psychologist | 1052578747 | Practice locations: Concord, NC |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
236 Le Phillip CT NE
Suite D
Concord, NC 28025-1917
Phone 70461415656
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Concord, NC
- NPI 1003730789
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785974400000",
"number": "1386709350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1351",
"city": "CONCORD",
"state": "NC",
"postal_code": "280261351",
"telephone_number": "704-614-1565",
"fax_number": "704-342-1884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "236 LEPHILLIP CT",
"address_2": "SUITE D",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251917",
"telephone_number": "704-342-1812",
"fax_number": "704-342-1884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEDESCHI",
"first_name": "RICHARD",
"middle_name": "GLENN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2026-08-06",
"certification_date": "2026-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.