Healthcare Provider Details

I. General information

NPI: 1366426819
Provider Name (Legal Business Name): MARVIN BURT POSTON JR. PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 MOCKINGBIRD LN SUITE 212
CHARLOTTE NC
28209-3236
US

IV. Provider business mailing address

1226 ESTATE AVE NO. 2024
CHARLOTTE NC
28209-0221
US

V. Phone/Fax

Practice location:
  • Phone: 704-522-8490
  • Fax:
Mailing address:
  • Phone: 704-517-4145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number1746
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1746
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1746
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1746
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: