NPIMap

Organization Active NPI

Mecklenburg Psychological Group

  • Clinical Psychologist
  • Charlotte, NC
National Provider Identifier
1952472540
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MECKLENBURG PSYCHOLOGICAL GROUP
Practice address
1132 Greenwood CLFS
Charlotte, NC 28204-2821
Phone
(704) 376-6577
Fax
(704) 335-8941
NPI assigned
Nov 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John T Wheeler, PHDNPI 1952448516
Title
President
Phone
(704) 376-6577

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
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

1132 Greenwood CLFS
Charlotte, NC 28204-2821

Mailing address

1132 Greenwood CLFS
Charlotte, NC 28204-2821
Phone (704) 376-6577

Other identifiers 1

IdentifierTypeStateIssuer
0246HOtherNCBLUE CROSS BLUE SHIELD #

National Provider Directory

National Provider Directory

Locations

1132 Greenwood Clfs
Charlotte, NC 28204
Phone 7043766577 ext. 11

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952472540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 GREENWOOD CLFS",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042821",
            "telephone_number": "704-376-6577",
            "fax_number": "704-335-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 GREENWOOD CLFS",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042821",
            "telephone_number": "704-376-6577",
            "fax_number": "704-335-8941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECKLENBURG PSYCHOLOGICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-376-6577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD #",
            "identifier": "0246H",
            "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 Aug 22, 2020; 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.