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NPI Code Detail

MEDICARE: THOMPSON CHILD AND FAMILY FOCUS

MEDICARE: THOMPSON CHILD AND FAMILY FOCUS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194962548
Entity Type Code : Organization
Provider Name (Legal Business Name) : THOMPSON CHILD AND FAMILY FOCUS
Provider Business Mailing Address
First Line : 6800 SAINT PETERS LN
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-8458
Country : US
Telephone Number : 704-536-0375
Fax Number : 704-531-9266
Provider Business Practice Location Address
First Line : 769 N WENDOVER RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-1118
Country : US
Telephone Number : 704-536-0375
Fax Number : 704-531-9266
Authorized Official
Title or Position : ACCOUNTS RECEIVABLE
Name : MARY ELIZABETH PORRAS KANTROWITZ
Credential :
Telephone Number : 704-536-0375
Provider Enumeration Date : 01/07/2009
Last Update Date : 12/13/2017

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1760608632 — MS. KATHERINE A JOHNS LMHC
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Directions to “THOMPSON CHILD AND FAMILY FOCUS ” Practice Location

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