Active NPI
Deborah Hall Proffitt, M.A.
- Psychologist
- Charlotte, NC
National Provider Identifier
1629020003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2443
- Practice address
- 4425 Randolph Rd
Suite 206
Charlotte, NC 28211-2348 - Phone
- (704) 609-4006
- Fax
- (704) 442-1656
- NPI assigned
- May 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2443 | NC | |
| Psychologist | 103T00000X | 2443 | NC | Primary |
Addresses
Primary practice location
4425 Randolph Rd
Suite 206
Charlotte, NC 28211-2348
Mailing address
2705 Tanglewood LN
Charlotte, NC 28211-1646
Phone (704) 442-1656
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2443 | Other | NC | LICENSE- PSYCHOLOGICAL A. |
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2443 | NC | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1629020003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2705 TANGLEWOOD LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111646",
"telephone_number": "704-442-1656",
"fax_number": "704-442-1656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4425 RANDOLPH RD",
"address_2": "SUITE 206",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282112348",
"telephone_number": "704-609-4006",
"fax_number": "704-442-1656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROFFITT",
"first_name": "DEBORAH",
"middle_name": "HALL",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-16",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "2443",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "2443",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE- PSYCHOLOGICAL A.",
"identifier": "2443",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.