Dr Heidar A Modaresi, PHD is a
Psychologist - Clinical based in Rock Hill, South Carolina. Dr Heidar A Modaresi is licensed to practice in South Carolina (license number 0575) and his current practice location is
3060 Wimbledon Ln, Rock Hill, South Carolina. He can be reached at his office (for appointments etc.) via phone at
(803) 366-9791.
NPI number for Dr Heidar A Modaresi is 1619920980 and his current mailing address is 3060 Wimbledon Ln, Rock Hill, South Carolina. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1619920980.
Healthcare Provider's Profile
| Full Name | Dr Heidar A Modaresi |
|---|
| Gender | Male |
|---|
| Speciality | Psychologist - Clinical |
|---|
| Location | 3060 Wimbledon Ln, Rock Hill, South Carolina |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1619920980
- Provider Enumeration Date: 05/18/2006
- Last Update Date: 09/02/2010
Medical Identifiers
Medical identifiers for Dr Heidar A Modaresi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619920980 | NPI | - | NPPES |
| PS0221 | Medicaid | SC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 1973 (North Carolina) | Secondary |
| 101YM0800X | Counselor - Mental Health | 0575 (South Carolina) | Secondary |
| 103TB0200X | Psychologist - Cognitive & Behavioral | 0575 (South Carolina) | Secondary |
| 103TB0200X | Psychologist - Cognitive & Behavioral | 1973 (North Carolina) | Secondary |
| 103TC0700X | Psychologist - Clinical | 0575 (South Carolina) | Primary |
| 103TC0700X | Psychologist - Clinical | 1973 (North Carolina) | Secondary |
| 103T00000X | Psychologist | 0575 (South Carolina) | Secondary |
| 103T00000X | Psychologist | 1973 (North Carolina) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Heidar A Modaresi is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Heidar A Modaresi, PHD
3060 Wimbledon Ln,
Rock Hill, SC 29732-9249
Ph: (803) 366-9791 | Dr Heidar A Modaresi, PHD
3060 Wimbledon Ln,
Rock Hill, SC 29732-9249
Ph: (803) 366-9791 |
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