MEDICARE: HEALTH-PRO MENTAL HEALTH SERVICES PLLC

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
1	208D00000X	General Practice Physician	9700767	NC
2	2084P0800X	Psychiatry Physician	9700767	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DE9089	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	013HP	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1235184813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH-PRO MENTAL HEALTH SERVICES PLLC

Provider Business Mailing Address
First Line	:	6700 FAIRVIEW RD
Second Line	:	SUITE 420
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-3324
Country	:	US
Telephone Number	:	704-248-2820
Fax Number	:	919-882-9135

Provider Business Practice Location Address
First Line	:	6700 FAIRVIEW RD
Second Line	:	SUITE 420
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-3324
Country	:	US
Telephone Number	:	704-248-2820
Fax Number	:	919-882-9135

Authorized Official
Title or Position	:	CEO
Name	:	DR. JAMES RICHARD SOWELL
Credential	:	MD
Telephone Number	:	704-248-2820

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	07/10/2009

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Directions to “HEALTH-PRO MENTAL HEALTH SERVICES PLLC ” Practice Location

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