NPI 1891193918

Carolina Behavioral Medicine, PA

Organisation Psychologist Concord, NC

Practice location

Address: 1036 Branchview Dr Suite 201, Concord, NC 28025-2998
Phone: (704) 659-3541
Fax: (888) 977-3202
Mailing address: 366 George W Liles Pkwy NW STE 52, Concord, NC 28027-2406

Authorised official

Name: Richard Cauley Kennerly
Title: Owner
Phone: (704) 659-3541

Registered specialties

Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103T00000X Licence 4561 (NC)

Other Psychologist providers in North Carolina →

Registry record

NPI: 1891193918
Entity type: Organization
NPI issued: 6 Dec 2014
Record last updated: 24 Apr 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.