Carolina Psych Group, PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

633 Issued in NC

Legal business name

CAROLINA PSYCH GROUP, PA

Practice address

515 Brookdale Dr
Statesville, NC 28677-4107

Phone

(704) 873-1697

NPI assigned

May 17, 2006

Last updated

Aug 22, 2020By 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. James A Powell, PSY.D.NPI 1023119922

Title

Ceo/Clinical Psychologist

Phone

(704) 873-1697

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• James Allen Powell, PSY.D.

  • Clinical Psychologist
  • Fort Hood, TX
  • NPI 1023119922
  NPD (past) Authorized official

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730131863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BROOKDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774107",
            "telephone_number": "704-873-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 BROOKDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774107",
            "telephone_number": "704-873-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PSYCH GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "704-873-1697",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005112",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Health Proffesionals, Inc.
• Carolina Lab Diagnostics, LLC
• Carolina Neurology PA
• Carolina Orthopedics and Sports Medicine Specialists, PA
• Carolina Pain Consultants
• Carolina Rehab Incorporation
• Carolina Residential Services, Inc
• Carolina Residential Services, Inc
• Carolina Specialty Care, PA
• Carolina Specialty Care,PA

• Clinical Psychologist in Statesville, NC
• Providers in Statesville, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.