North Fourth Counseling and Psycological Services Group, PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3148 Issued in NC

Legal business name

NORTH FOURTH COUNSELING AND PSYCOLOGICAL SERVICES GROUP, PLLC

Practice address

2018 Fort Bragg Rd
Suite 110
Fayetteville, NC 28303-7037

Phone

(910) 273-0265

Fax

(910) 483-3400

NPI assigned

Jun 28, 2016

Last updated

Jun 28, 2016By 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

Ronald Ray Johnson Jr., PSYD

Title

Co-Owner

Phone

(910) 273-0265

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467072000000",
    "number": "1619328077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 FT. BRAGG ROAD",
            "address_2": "SUITE 110",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283037037",
            "telephone_number": "910-273-0265",
            "fax_number": "910-483-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 FORT BRAGG RD",
            "address_2": "SUITE 110",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283037037",
            "telephone_number": "910-273-0265",
            "fax_number": "910-483-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FOURTH COUNSELING AND PSYCOLOGICAL SERVICES GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "910-273-0265",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Carolina CVS Pharmacy LLC (CVS Pharmacy #04095)
• North Carolina Hyperbarics, LLC
• North Carolina Interventional Pain - a LLC
• North Carolina Physicians Eyecare Group, P.C.
• North Carolina Psych Services PLLC
• Northland Hearing Center, Inc. (Audibel)
• Madison Northrop
• Northside Family Eye Care Optometry, PA
• Northside Primary & Urgent Care
• Northside Urgent Care, Inc. (Northside Urgent Care)

• Psychologist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.