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General NPI Number Information
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NPI Number | 1285971374
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Entity Type | Organization
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Legal Business Name | CATAWBA VALLEY PSYCHOLOGICAL ASSOCIATES
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Dates
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Enumeration Date | 01/09/2013
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Last Update Date | 01/09/2013
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Provider Practice Location Address
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Address Line | 211-B HIGHWAY 127 S.E., SUITE 130
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City | HICKORY
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State | NC
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Zip | 28602-3541
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Country | US
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Telephone | 828-848-8278
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Fax | 828-270-7868
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Provider Business Mailing Address
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Address Line | 75 BROWNING DR
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City | TAYLORSVILLE
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State | NC
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Zip | 28681-6642
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Country | US
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Telephone | 828-848-8278
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | MRS. ROBERTA ANN SHANNON-KIRBY
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Credential | MA/CAS, LPA
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Telephone | 828-848-8278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 3679
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3679
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License Number State | NC
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