Organization Active NPI

Mosaic Psychological Center, PLLC

  • Clinical Psychologist
  • Charlotte, NC
National Provider Identifier
1659797686
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3736 Issued in NC
Legal business name
MOSAIC PSYCHOLOGICAL CENTER, PLLC
Practice address
425 S Sharon Amity Rd Ste D
Charlotte, NC 28211-2841
Phone
(704) 774-0459
Fax
(704) 910-0071
NPI assigned
Mar 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Authorized official

Name
Dr. Robin Navarro, PSY.D.NPI 1477735231
Title
Licensed Psychologist
Phone
(704) 774-0459

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 3736 NC Primary

Addresses

Primary practice location

425 S Sharon Amity Rd Ste D
Charlotte, NC 28211-2841

Mailing address

425 S Sharon Amity Rd Ste D
Charlotte, NC 28211-2841
Phone (704) 774-0459

Other identifiers 1

IdentifierTypeStateIssuer
6001157MedicaidNC

National Provider Directory

National Provider Directory

Locations

425 S Sharon Amity Rd
Ste D
Charlotte, NC 28211
Phone (704) 362-1315

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683244800000",
    "number": "1659797686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S SHARON AMITY RD STE D",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112841",
            "telephone_number": "704-774-0459",
            "fax_number": "704-910-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S SHARON AMITY RD STE D",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112841",
            "telephone_number": "704-774-0459",
            "fax_number": "704-910-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC PSYCHOLOGICAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-14",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A",
        "authorized_official_last_name": "NAVARRO",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "704-774-0459",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001157",
            "state": "NC"
        }
    ],
    "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 May 5, 2023; 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.