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NPI Code Detail

MEDICARE: SOUND PSYCHOLOGIAL SERVICES, PA

MEDICARE: SOUND PSYCHOLOGIAL SERVICES, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)1633640NC

General Provider Information

NPI Number : 1982117669
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUND PSYCHOLOGIAL SERVICES, PA
Provider Business Mailing Address
First Line : 100 N GADWALL CT
Second Line :
City : HAMPSTEAD
State : NC
Zip : 28443-7159
Country : US
Telephone Number : 910-538-5334
Fax Number :
Provider Business Practice Location Address
First Line : 3317 MASONBORO LOOP RD UNIT 160
Second Line :
City : WILMINGTON
State : NC
Zip : 28409-2970
Country : US
Telephone Number : 910-538-5334
Fax Number :
Authorized Official
Title or Position : PSYCHOLOGIST
Name : KIM LYNNE MILLER-URBAN
Credential : LPA
Telephone Number : 910-538-5334
Provider Enumeration Date : 11/16/2017
Last Update Date : 11/16/2017

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