Southeast Psychological Services, PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

SOUTHEAST PSYCHOLOGICAL SERVICES, PLLC

Practice address

6060 Piedmont Row Dr S
Suite 120
Charlotte, NC 28287-3884

Phone

(704) 552-0116

Fax

(704) 552-7550

NPI assigned

Dec 29, 2006

Last updated

Nov 25, 2014By 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

Frank W Gaskill III, PH.D.

Title

Managing Partner

Phone

(704) 552-0116

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Southeast Psychological Services PLLC

  • Clinical Psychologist
  • Charlotte, NC
  • NPI 1407090707

  O20040731000305

  Same enrollment

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.

• Marie Lewis

  • Professional Counselor
  • San Antonio, TX
  • NPI 1336786680

  NC

  Medicare reassignment NPD
• Barrie Ellen Morganstein, PHD

  • Psychologist
  • Charlotte, NC
  • NPI 1699859678
  Medicare reassignment

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1811053218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6060 PIEDMONT ROW DR S",
            "address_2": "SUITE 120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282873884",
            "telephone_number": "704-552-0116",
            "fax_number": "704-552-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 PIEDMONT ROW DR S",
            "address_2": "SUITE 120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282873884",
            "telephone_number": "704-552-0116",
            "fax_number": "704-552-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "GASKILL",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "704-552-0116",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "CO5021",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005111",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Bariatrics
• Southeast Family Care PLLC
• Southeast Pain Management Services, PLLC
• Southeast Pathology Consultants, Inc.
• Southeast Psychological Services PLLC
• Southeast Radiation Oncology Group, P.a.
• Southeast Radiology Associates PLLC
• Southeast Renal Associates PA
• Southeast Surgical Specialists, PLLC
• Southeast Vulvar Clinic, PLLC

• Psychologist in Charlotte, NC
• Providers in Charlotte, 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 25, 2014; 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.