Individual provider Active NPI

Stephanie Hosford, PSYD

  • Psychologist
  • Charlotte, NC
National Provider Identifier
1639844996
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
1515 Mockingbird LN Ste 580
Charlotte, NC 28209-1171
Phone
(704) 910-8381
Fax
(704) 981-8282
NPI assigned
Aug 10, 2021
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

1515 Mockingbird LN Ste 580
Charlotte, NC 28209-1171

Mailing address

1515 Mockingbird LN Ste 580
Charlotte, NC 28209-1171
Phone (704) 910-8381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 22, 2022 through Sep 22, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6217NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Base, PLLC Psychologist PastSince Aug 15, 2021 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1639844996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN STE 580",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091171",
            "telephone_number": "704-910-8381",
            "fax_number": "704-981-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN STE 580",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091171",
            "telephone_number": "704-910-8381",
            "fax_number": "704-981-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSFORD",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.