Carolina Neurobehavioral Service | |
7810 Ballantyne Commons Pkwy Suite 309 Charlotte NC 28277-3415 | |
(704) 319-5538 | |
(888) 703-9409 |
Full Name | Carolina Neurobehavioral Service |
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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 |
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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 |
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Provider Enumeration Date | 07/18/2012 |
Last Update Date | 01/02/2013 |
Medicare PECOS PAC ID | 2466605373 |
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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 |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1891824306 PECOS PAC ID: 2365486776 Enrollment ID: I20121228000383 |
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