NPIMap

Organization Active NPI

Charlotte Psychotherapy & Consultation Group

  • Forensic Psychologist
  • Charlotte, NC
National Provider Identifier
1821027988
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
2061 Issued in NC
Legal business name
CHARLOTTE PSYCHOTHERAPY & CONSULTATION GROUP
Practice address
417 S Sharon Amity Rd Ste a
Charlotte, NC 28211-2875
Phone
(704) 364-0452
Fax
(704) 364-5481
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Eric Deitchman, PH.D.NPI 1235155177
Title
President
Phone
(704) 364-0452

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 892 NC
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 1074 NC
Forensic PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TF0200X 2061 NC Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X C003965 NC

Addresses

Primary practice location

417 S Sharon Amity Rd Ste a
Charlotte, NC 28211-2875

Mailing address

417 S Sharon Amity Rd Ste a
Charlotte, NC 28211-2875
Phone (704) 364-0452

National Provider Directory

National Provider Directory

Locations

417 S Sharon Amity Rd
Ste A
Charlotte, NC 28211
Phone (704) 364-0452

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1821027988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 S SHARON AMITY RD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112875",
            "telephone_number": "704-364-0452",
            "fax_number": "704-364-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 S SHARON AMITY RD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112875",
            "telephone_number": "704-364-0452",
            "fax_number": "704-364-5481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE PSYCHOTHERAPY & CONSULTATION GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "DEITCHMAN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-364-0452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "892",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "1074",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Forensic",
            "state": "NC",
            "license": "2061",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C003965",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.