MEDICARE: DEDICATED PSYCHOLOGICAL SOLUTIONS, 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1770432866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEDICATED PSYCHOLOGICAL SOLUTIONS, PLLC

Provider Business Mailing Address
First Line	:	5008 GLENVIEW EXT DR
Second Line	:
City	:	STATESVILLE
State	:	NC
Zip	:	28677-2882
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18117 W CATAWBA AVE
Second Line	:
City	:	CORNELIUS
State	:	NC
Zip	:	28031-5641
Country	:	US
Telephone Number	:	315-225-8171
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DANITA BOWLING
Credential	:	PHD
Telephone Number	:	315-225-8171

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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