Organization Active NPI

Mosaic Psychological Services, PLLC

  • Adult Mental Health Clinic/Center
  • Wake Forest, NC
National Provider Identifier
1730968660
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MOSAIC PSYCHOLOGICAL SERVICES, PLLC
Practice address
1788 Heritage Center Dr Ste 202
Wake Forest, NC 27587-3972
Phone
(919) 298-2424
NPI assigned
Sep 28, 2023
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Rosanna Lora, PHDNPI 1043358997
Title
Clinical Psychologist
Phone
(919) 298-2424

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

NPPES NPI Registry

Primary practice location

1788 Heritage Center Dr Ste 202
Wake Forest, NC 27587-3972

Mailing address

11845 Retail Dr # 1056
Wake Forest, NC 27587-7352

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 28, 2023.

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1730968660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11845 RETAIL DR # 1056",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275877352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1788 HERITAGE CENTER DR STE 202",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873972",
            "telephone_number": "919-298-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "LORA",
        "authorized_official_first_name": "ROSANNA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "919-298-2424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.