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NPI Code Detail

MEDICARE: CHILD AND FAMILY DEVELOPMENT INC.

MEDICARE: CHILD AND FAMILY DEVELOPMENT INC.
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
1103TC2200XClinical Child & Adolescent PsychologistNC
2103TC2200XClinical Child & Adolescent Psychologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871697888
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILD AND FAMILY DEVELOPMENT INC.
Provider Business Mailing Address
First Line : 4012 PARK ROAD
Second Line : SUITE 200
City : CHARLOTTE
State : NC
Zip : 28209
Country : US
Telephone Number : 704-332-4834
Fax Number : 704-372-9653
Provider Business Practice Location Address
First Line : 4012 PARK RD
Second Line : SUITE 200
City : CHARLOTTE
State : NC
Zip : 28209-2377
Country : US
Telephone Number : 704-332-4834
Fax Number : 704-372-9653
Authorized Official
Title or Position : PRESIDENT
Name : MRS. PAM JONES
Credential :
Telephone Number : 704-332-4834
Provider Enumeration Date : 09/11/2006
Last Update Date : 01/29/2024

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Directions to “CHILD AND FAMILY DEVELOPMENT INC. ” Practice Location

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