NPIMap

Organization Active NPI

Outer Banks Psychological Services PLLC

  • Psychologist
  • Nags Head, NC
National Provider Identifier
1821861535
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
OUTER BANKS PSYCHOLOGICAL SERVICES PLLC
Practice address
110 W Wood Hill Dr
Nags Head, NC 27959-9394
Phone
(252) 216-2589
NPI assigned
Nov 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Authorized official

Name
Dr. Sheena Berry Fuller, PHDNPI 1154772937
Title
Owner
Phone
(252) 475-0378

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
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

110 W Wood Hill Dr
Nags Head, NC 27959-9394

Mailing address

PO Box 1355
Nags Head, NC 27959
Phone (252) 216-2589

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.

NPI Registry JSON

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1821861535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1355",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "27959",
            "telephone_number": "252-216-2589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W WOOD HILL DR",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279599394",
            "telephone_number": "252-216-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTER BANKS PSYCHOLOGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "SHEENA",
        "authorized_official_middle_name": "BERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-475-0378",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nags Head, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.