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General NPI Number Information
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NPI Number | 1497100689
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Entity Type | Organization
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Legal Business Name | UPTOWN PSYCHOTHERAPY, PLLC
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 1818 LOMBARDY CIR
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City | CHARLOTTE
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State | NC
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Zip | 28203-6056
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Country | US
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Telephone | 704-412-4046
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Fax | 800-682-8178
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Provider Business Mailing Address
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Address Line | 1818 LOMBARDY CIR
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City | CHARLOTTE
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State | NC
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Zip | 28203-6056
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Country | US
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Telephone | 704-412-4046
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Fax | 800-682-8178
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Authorized Official
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Title or Position | CO-OWNER
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Name | MEREDITH STEWART
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Credential | LCSW
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Telephone | 704-333-8861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4838
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A10859
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C004981
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C004673
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C003040
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License Number State | NC
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