| Agape Psychological Consortium | |
|
4160 Piedmont Pkwy Ste 207 Greensboro NC 27410-8174 | |
| (336) 855-4649 | |
| (336) 261-6488 |
| Full Name | Agape Psychological Consortium |
|---|---|
| Speciality | Psychologist |
| Location | 4160 Piedmont Pkwy Ste 207, Greensboro, North Carolina |
| Authorized Official Name and Position | Edward Franklyn Morris (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3368554649 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Psychological Consortium 4160 Piedmont Pkwy Ste 207 Greensboro NC 27410-8174 Ph: (336) 855-4649 | Agape Psychological Consortium 4160 Piedmont Pkwy Ste 207 Greensboro NC 27410-8174 Ph: (336) 855-4649 |
| NPI Number | 1679746309 |
|---|---|
| Provider Enumeration Date | 04/02/2008 |
| Last Update Date | 08/22/2023 |
| Certification Date | 08/22/2023 |
| Medicare PECOS PAC ID | 5597045872 |
|---|---|
| Medicare Enrollment ID | O20161201002275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679746309 | NPI | - | NPPES |
| 6000958 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1310 (North Carolina) | Primary |
| Provider Name | Edward F Morris |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1972716009 PECOS PAC ID: 7911096714 Enrollment ID: I20170105000726 |
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