Charlotte Psychological Assessment, PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3520 Issued in NC

Legal business name

CHARLOTTE PSYCHOLOGICAL ASSESSMENT, PA

Practice address

1811 Sardis Rd N
Suite 207
Charlotte, NC 28270-1426

Phone

(704) 841-1163

Fax

(704) 841-1164

NPI assigned

May 1, 2008

Last updated

May 1, 2008By 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. Nicole L Cantley, PH.D.NPI 1558533968

Title

President

Phone

(704) 841-1163

Specialties & licenses 1

Addresses

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.

• Nicole Lacoste Cantley, PH.D.

  • Clinical Psychologist
  • Charlotte, NC
  • NPI 1558533968
  Authorized official Same address or phone

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1801062674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 SARDIS RD N",
            "address_2": "SUITE 207",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282701426",
            "telephone_number": "704-841-1163",
            "fax_number": "704-841-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 SARDIS RD N",
            "address_2": "SUITE 207",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282701426",
            "telephone_number": "704-841-1163",
            "fax_number": "704-841-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE PSYCHOLOGICAL ASSESSMENT, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "CANTLEY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-841-1163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Charlotte, NC
• Providers in Charlotte, 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 May 1, 2008; 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.