Edwin Reisfeld PHD PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3748 Issued in NC

Legal business name

EDWIN REISFELD PHD PA

Practice address

15720 John J Delaney Dr
Suite 300
Charlotte, NC 28277-3430

Phone

(704) 927-5881

Fax

(704) 944-3201

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Edwin H Reisfeld, PHD

Title

Owner/Psychologist

Phone

(704) 927-5881

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Eastside Counseling Center Doing business as

Locations

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313971200000",
    "number": "1902010804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52511 WINCHESTER STREET",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29707",
            "telephone_number": "704-927-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15720 JOHN J DELANEY DR",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773430",
            "telephone_number": "704-927-5881",
            "fax_number": "704-944-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWIN REISFELD PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2011-08-22",
        "status": "A",
        "authorized_official_last_name": "REISFELD",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "704-927-5881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2826004",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL",
            "identifier": "2826004A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastside Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelly Marie Edwards
• Shyeisha Edwards
• Wanda Edwards
• Grace Edwardsen
• Edwin C. Bryson, III, DDS, PA
• Eelio, LLC
• Efficient Care Services Inc.
• Alison Andrews Efird, FNP
• Mattie Elizabeth Efird
• Jennifer Marie Efune, M.A., LPCA

• Clinical Psychologist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; 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.