NPIMap

Organization Active NPI

Southeastpsych Ballantyne, PLLC

  • Psychologist
  • Charlotte, NC
National Provider Identifier
1902318249
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
SOUTHEASTPSYCH BALLANTYNE, PLLC
Practice address
15720 Brixham Hill Ave Ste 150
Charlotte, NC 28277-4785
Phone
(704) 970-4791
Fax
(704) 970-4794
NPI assigned
Oct 26, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Authorized official

Name
Karen Arrowood Amrhein
Title
Director of Finance
Phone
(704) 552-0116

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

15720 Brixham Hill Ave Ste 150
Charlotte, NC 28277-4785

Mailing address

15720 Brixham Hill Ave Ste 150
Charlotte, NC 28277-4785
Phone (704) 970-4791

National Provider Directory

National Provider Directory

Locations

6060 Piedmont Row Dr S
Ste 120
Charlotte, NC 28287
Phone (704) 552-0116

15720 Brixham Hill Ave
Ste 150
Charlotte, NC 28277
Phone (704) 970-4791

Practitioners & affiliated clinicians

Practitioners 5

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": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1902318249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15720 BRIXHAM HILL AVE STE 150",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774785",
            "telephone_number": "704-970-4791",
            "fax_number": "704-970-4794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15720 BRIXHAM HILL AVE STE 150",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774785",
            "telephone_number": "704-970-4791",
            "fax_number": "704-970-4794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTPSYCH BALLANTYNE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "AMRHEIN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "ARROWOOD",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "704-552-0116"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Dec 4, 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.