| Carolina Neurobehavioral Service | |
|
7810 Ballantyne Commons Pkwy Suite 309 Charlotte NC 28277-3415 | |
| (704) 319-5538 | |
| (888) 703-9409 |
| Full Name | Carolina Neurobehavioral Service |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 7810 Ballantyne Commons Pkwy, Charlotte, North Carolina |
| Authorized Official Name and Position | Lisa Anne Sworowski (OWNER/NEURPSYCHOLOGIST) |
| Authorized Official Contact | 7043195538 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Neurobehavioral Service 7810 Ballantyne Commons Pkwy Suite 300 Charlotte NC 28277-3415 Ph: (704) 319-5538 | Carolina Neurobehavioral Service 7810 Ballantyne Commons Pkwy Suite 309 Charlotte NC 28277-3415 Ph: (704) 319-5538 |
| NPI Number | 1053666834 |
|---|---|
| Provider Enumeration Date | 07/18/2012 |
| Last Update Date | 01/02/2013 |
| Medicare PECOS PAC ID | 2466605373 |
|---|---|
| Medicare Enrollment ID | O20121228000397 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053666834 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 4230 (North Carolina) | Primary |
| 103TC0700X | Psychologist - Clinical | 4230 (North Carolina) | Secondary |
| Provider Name | Lisa A Sworowski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891824306 PECOS PAC ID: 2365486776 Enrollment ID: I20121228000383 |
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