Maritime Psychological Services PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

MARITIME PSYCHOLOGICAL SERVICES PLLC

Practice address

1213 Culbreth Dr Ste 104
Wilmington, NC 28405-3639

Phone

(910) 509-7216

NPI assigned

Nov 10, 2022

Last updated

Nov 10, 2022By 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

Dr. Mary Engelstatter, PHDNPI 1740266220

Title

Owner

Phone

(910) 509-7216

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Mary Engelstatter, PHD

  • Psychologist
  • Jacksonville, NC
  • NPI 1740266220
  NPD Authorized official
• Jonathan Marmorstein, MA, LPA

  • Psychologist
  • Wilmington, NC
  • NPI 1184783722
  NPD (past)

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1700594504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 CULBRETH DR STE 104",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053639",
            "telephone_number": "910-509-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 CULBRETH DR STE 104",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053639",
            "telephone_number": "910-509-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARITIME PSYCHOLOGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "ENGELSTATTER",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-509-7216",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.