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General NPI Number Information
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NPI Number | 1144747452
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Entity Type | Organization
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Legal Business Name | PRISM PSYCHOLOGICAL SERVICES, PC
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 10130 PERIMETER PKWY STE 200
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City | CHARLOTTE
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State | NC
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Zip | 28216-0197
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Country | US
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Telephone | 704-212-2020
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Fax | 704-212-2020
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Provider Business Mailing Address
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Address Line | 10130 PERIMETER PKWY STE 200
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City | CHARLOTTE
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State | NC
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Zip | 28216-0197
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Country | US
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Telephone | 704-212-2020
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Fax | 704-212-2020
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD FIELD
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Credential | PHD
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Telephone | 704-212-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4903
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License Number State | NC
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