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General NPI Number Information
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NPI Number | 1023116910
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Entity Type | Organization
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Legal Business Name | UNIVERSITY PSYCHOLOGICAL ASSOCIATES, P.A.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 10001 OLD CONCORD ROAD
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City | CHARLOTTE
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State | NC
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Zip | 28213
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Country | US
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Telephone | 704-547-1483
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Fax | 704-547-0052
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Provider Business Mailing Address
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Address Line | 10001 OLD CONCORD RD
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City | CHARLOTTE
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State | NC
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Zip | 28213-3646
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Country | US
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Telephone | 704-547-1483
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Fax | 704-547-0052
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. AMANDA GREENE ADAMS
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Credential |
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Telephone | 704-547-1483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1067
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License Number State | NC
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