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General NPI Number Information
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NPI Number | 1396546115
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Entity Type | Organization
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Legal Business Name | ASPIRE PSYCHOLOGICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 1515 MOCKINGBIRD LN
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City | CHARLOTTE
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State | NC
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Zip | 28209-3236
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Country | US
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Telephone | 800-883-9087
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Fax | 732-960-5071
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Provider Business Mailing Address
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Address Line | 1999 CEDARBRIDGE AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-7048
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Country | US
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Telephone | 732-837-0606
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOE JEREMIAS
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Credential | COO
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Telephone | 347-277-5090
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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 |
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License Number State |
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