Healthcare Provider Details

I. General information

NPI: 1235184813
Provider Name (Legal Business Name): HEALTH-PRO MENTAL HEALTH SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 07/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 FAIRVIEW RD SUITE 420
CHARLOTTE NC
28210-3324
US

IV. Provider business mailing address

6700 FAIRVIEW RD SUITE 420
CHARLOTTE NC
28210-3324
US

V. Phone/Fax

Practice location:
  • Phone: 704-248-2820
  • Fax: 919-882-9135
Mailing address:
  • Phone: 704-248-2820
  • Fax: 919-882-9135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9700767
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number9700767
License Number StateNC

VIII. Authorized Official

Name: DR. JAMES RICHARD SOWELL
Title or Position: CEO
Credential: MD
Phone: 704-248-2820