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CAROLINA BEHAVIORAL MEDICINE PA NPI 1891193918


NPI Information

NPI: 1891193918
Provider Name: CAROLINA BEHAVIORAL MEDICINE, PA
Classification: Psychologist - 103T00000X
Entity Type: Organization

CLIA Number: 34D2060726

Address:
1036 BRANCHVIEW DR
SUITE 201
CONCORD, NC
ZIP 28025
Phone: (704) 659-3541
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CAROLINA BEHAVIORAL MEDICINE, PA is a psychologist in Concord, NC. The provider is a psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. CAROLINA BEHAVIORAL MEDICINE, PA NPI is 1891193918. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1036 BRANCHVIEW DR
SUITE 201
CONCORD, NC
ZIP 28025-998
Phone: (704) 659-3541
Fax: (888) 977-3202

The provider's authorized official is Richard Cauley Kennerly .
The authorized official title is Owner and has the following contact phone number (704) 659-3541.

The CLIA number assigned to this NPI record is 34D2060726 - other - rehabilitation facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/6/2014 and was last updated on 4/24/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103T00000XPsychologist4561NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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