NPIMap

Organization Active NPI

Child and Family Development Inc.

  • Clinical Child & Adolescent Psychologist
  • Charlotte, NC
National Provider Identifier
1871697888
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Legal business name
CHILD AND FAMILY DEVELOPMENT INC.
Practice address
4012 Park Rd
Suite 200
Charlotte, NC 28209-2377
Phone
(704) 332-4834
Fax
(704) 372-9653
NPI assigned
Sep 11, 2006
Last updated
Jan 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Authorized official

Name
Mrs. Pam Jones
Title
President
Phone
(704) 332-4834

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X NC
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X Primary

Addresses

Primary practice location

4012 Park Rd
Suite 200
Charlotte, NC 28209-2377

Mailing address

4012 Park Road
Suite 200
Charlotte, NC 28209
Phone (704) 332-4834

Other identifiers 2

IdentifierTypeStateIssuer
7211539MedicaidNC
720103CMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Child and Family Development Counselors2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4012 Park Rd
Ste 200
Charlotte, NC 28209
Phone (704) 332-4834

11940 Carolina Place Pkwy
Ste 200
Pineville, NC 28134
Phone (704) 372-9652

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1871697888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4012 PARK ROAD",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28209",
            "telephone_number": "704-332-4834",
            "fax_number": "704-372-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 PARK RD",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092377",
            "telephone_number": "704-332-4834",
            "fax_number": "704-372-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD AND FAMILY DEVELOPMENT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-332-4834",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211539",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "720103C",
            "state": "NC"
        }
    ],
    "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 Jan 29, 2024; 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.