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NPI Code Detail

MEDICARE: THERAPY GROUP OF CHARLOTTE LLC

MEDICARE: THERAPY GROUP OF CHARLOTTE LLC
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
1103TC1900XCounseling Psychologist

General Provider Information

NPI Number : 1841962602
Entity Type Code : Organization
Provider Name (Legal Business Name) : THERAPY GROUP OF CHARLOTTE LLC
Provider Business Mailing Address
First Line : 125 REMOUNT RD STE C1
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-6459
Country : US
Telephone Number : 980-580-3532
Fax Number :
Provider Business Practice Location Address
First Line : 125 REMOUNT RD STE C1
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-6459
Country : US
Telephone Number : 980-580-3532
Fax Number :
Authorized Official
Title or Position : PARTNER
Name : DR. BRADLEY R BRENNER
Credential : PHD
Telephone Number : 202-986-5941
Provider Enumeration Date : 09/30/2021
Last Update Date : 09/30/2021

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Directions to “THERAPY GROUP OF CHARLOTTE LLC ” Practice Location

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