Healthcare Provider Details

I. General information

NPI: 1982812053
Provider Name (Legal Business Name): JW LOY III M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MR. CHRIS LOY

II. Dates (important events)

Enumeration Date: 05/20/2007
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 S ABERNETHY ST
LINCOLNTON NC
28092-3805
US

IV. Provider business mailing address

107 S ABERNETHY ST
LINCOLNTON NC
28092-3805
US

V. Phone/Fax

Practice location:
  • Phone: 704-732-9354
  • Fax: 704-732-9354
Mailing address:
  • Phone: 704-732-9354
  • Fax: 704-732-9354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number1240
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number1240
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number1240
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1240
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number1240
License Number StateNC
# 6
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1240
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number1240
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: