Individual provider Active NPI

Robert Jay Maccaughelty, PH.D.

  • Marriage & Family Therapist
  • Charlotte, NC
National Provider Identifier
1891829438
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
73 Issued in NC
Practice address
1515 Mockingbird LN
Ste 570
Charlotte, NC 28209-3236
Phone
(704) 527-1220
Fax
(704) 527-1208
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
Yes

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2561 NC
Marriage & Family Therapist 106H00000X 73 NC Primary

Addresses

Primary practice location

1515 Mockingbird LN
Ste 570
Charlotte, NC 28209-3236

Mailing address

1515 Mockingbird LN
Ste 570
Charlotte, NC 28209-3236
Phone (704) 527-1220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
73NCMDAdult Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1891829438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN",
            "address_2": "STE 570",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093236",
            "telephone_number": "704-527-1220",
            "fax_number": "704-527-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN",
            "address_2": "STE 570",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093236",
            "telephone_number": "704-527-1220",
            "fax_number": "704-527-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCAUGHELTY",
        "first_name": "ROBERT",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2561",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "73",
            "primary": true
        }
    ],
    "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.