Organization Active NPI

Fortitude Psychological Services, Inc.

  • Clinical Psychologist
  • Wilmington, NC
National Provider Identifier
1780231878
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
FORTITUDE PSYCHOLOGICAL SERVICES, INC.
Practice address
1804 Glen Meade Rd
Wilmington, NC 28403-6023
Phone
(910) 799-7557
Fax
(910) 799-7558
NPI assigned
Aug 22, 2019
Last updated
Apr 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Authorized official

Name
Erika McCullough-Simpson, MA, LPANPI 1457480667
Title
Ceo/Owner
Phone
(910) 620-8575

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 Psychologist 103TC0700X Primary

Addresses

Primary practice location

1804 Glen Meade Rd
Wilmington, NC 28403-6023

Mailing address

1804 Glen Meade Rd
Wilmington, NC 28403-6023
Phone (910) 799-7557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250623000473 NC Part B Supplier - Clinic/Group Practice 8729590104 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmington, NC

National Provider Directory

National Provider Directory

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": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1780231878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 GLEN MEADE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036023",
            "telephone_number": "910-799-7557",
            "fax_number": "910-799-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 GLEN MEADE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036023",
            "telephone_number": "910-799-7557",
            "fax_number": "910-799-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTITUDE PSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-22",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH-SIMPSON",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "910-620-8575",
        "authorized_official_credential": "MA, LPA"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.