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General NPI Number Information
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NPI Number | 1306183546
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Entity Type | Organization
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Legal Business Name | EXCEL PSYCHIATRIC ASSOCIATES, PA
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Dates
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Enumeration Date | 01/08/2013
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 10225 HICKORYWOOD HILL AVE SUITE B
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-3431
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Country | US
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Telephone | 704-457-9292
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Fax | 704-274-5783
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Provider Business Mailing Address
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Address Line | 10225 HICKORYWOOD HILL AVE SUITE B
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-3431
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Country | US
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Telephone | 704-457-9292
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Fax | 704-274-5783
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Authorized Official
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Title or Position | CO-OWNER
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Name | TIFFANY CHRISTINE CHEPKE
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Credential | LCSW
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Telephone | 704-457-9292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C007832
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2009-00088
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License Number State | NC
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