Active NPI
Sally M Duffy, PHD
- Psychologist
- Charlotte, NC
National Provider Identifier
1396704458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1683
- Practice address
- 6845 Fairview Rd
Southpark Behavioral Medicine Specialists PA
Charlotte, NC 28210 - Phone
- (704) 442-9065
- Fax
- (704) 969-1175
- NPI assigned
- Mar 18, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1683 | NC | Primary |
Addresses
Primary practice location
6845 Fairview Rd
Southpark Behavioral Medicine Specialists PA
Charlotte, NC 28210
Mailing address
6845 Fairview Rd
Southpark Behavioral Medicine Specialists PA
Charlotte, NC 28210
Phone (704) 442-9065
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2021 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1396704458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6845 FAIRVIEW RD",
"address_2": "SOUTHPARK BEHAVIORAL MEDICINE SPECIALISTS PA",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28210",
"telephone_number": "704-442-9065",
"fax_number": "704-969-1175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6845 FAIRVIEW RD",
"address_2": "SOUTHPARK BEHAVIORAL MEDICINE SPECIALISTS PA",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28210",
"telephone_number": "704-442-9065",
"fax_number": "704-969-1175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUFFY",
"first_name": "SALLY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-18",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "1683",
"primary": true
}
],
"identifiers": [],
"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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.