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General NPI Number Information
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NPI Number | 1891727681
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Entity Type | Organization
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Legal Business Name | SOUTHERN HIGHLANDS PSYCHOLOGICAL ASSOCIATES PA
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 02/20/2012
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Provider Practice Location Address
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Address Line | 31 COLLEGE PL SUITE D-203
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City | ASHEVILLE
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State | NC
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Zip | 28801-2483
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Country | US
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Telephone | 828-350-1433
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Fax | 828-350-1434
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Provider Business Mailing Address
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Address Line | 31 COLLEGE PL SUITE D-203
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City | ASHEVILLE
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State | NC
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Zip | 28801-2483
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Country | US
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Telephone | 828-350-1433
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Fax | 828-350-1434
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. CHARLES MARK KNECHT
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Credential | PSY,D
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Telephone | 828-350-1433
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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 | COO5255
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1863
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License Number State | NC
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