MEDICARE: DR. MARVIN BURT POSTON JR. PSY.D.

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	101YP1600X	Pastoral Counselor
2	103TB0200X	Cognitive & Behavioral Psychologist	1746	NC
3	103TC0700X	Clinical Psychologist	1746	NC
4	103TC1900X	Counseling Psychologist	1746	NC
5	103T00000X	Psychologist	1746	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	VARIOUS COMPANIES	OTHER		PROVIDER NUMBERS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0362H	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1366426819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARVIN BURT POSTON JR. PSY.D.

Provider Business Mailing Address
First Line	:	1226 ESTATE AVE
Second Line	:	NO. 2024
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-0221
Country	:	US
Telephone Number	:	704-517-4145
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 MOCKINGBIRD LN
Second Line	:	SUITE 212
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-3236
Country	:	US
Telephone Number	:	704-522-8490
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	09/11/2025

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Directions to “ DR. MARVIN BURT POSTON JR. PSY.D.” Practice Location

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