| Carolina Psychological Health Services | |
|
1703 Country Club Rd Ste 204 Jacksonville NC 28546-6098 | |
| (910) 347-3010 | |
| (910) 347-6137 |
| Full Name | Carolina Psychological Health Services |
|---|---|
| Speciality | Psychologist |
| Location | 1703 Country Club Rd Ste 204, Jacksonville, North Carolina |
| Authorized Official Name and Position | Victoria J Ewing (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 9103473010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Psychological Health Services 1703 Country Club Rd Suite 204 Jacksonville NC 28546-6006 Ph: (910) 347-3010 | Carolina Psychological Health Services 1703 Country Club Rd Ste 204 Jacksonville NC 28546-6098 Ph: (910) 347-3010 |
| NPI Number | 1770561193 |
|---|---|
| Provider Enumeration Date | 01/05/2006 |
| Last Update Date | 05/28/2023 |
| Certification Date | 05/28/2023 |
| Medicare PECOS PAC ID | 9436059219 |
|---|---|
| Medicare Enrollment ID | O20040109000156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770561193 | NPI | - | NPPES |
| 0296J | Other | NC | BC/BS |
| 6005337 | Medicaid | NC | |
| 890296J | Medicaid | NC |
| Provider Name | Robert Seigel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912043050 PECOS PAC ID: 9931295664 Enrollment ID: I20071011000093 |
| Provider Name | Gerolf H Engelstatter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932185477 PECOS PAC ID: 9032019815 Enrollment ID: I20100902000953 |
| Provider Name | Ruth P Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578584215 PECOS PAC ID: 5294919502 Enrollment ID: I20110412000242 |
| Provider Name | Mary T Engelstatter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740266220 PECOS PAC ID: 5294053146 Enrollment ID: I20150406001418 |
| Provider Name | Thomas C Stein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356478523 PECOS PAC ID: 6103817788 Enrollment ID: I20170718001798 |
| Provider Name | Mari T Rhodes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558890269 PECOS PAC ID: 4880965771 Enrollment ID: I20170810003799 |
| Provider Name | Amanda Caroline Gurganus |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770711806 PECOS PAC ID: 4789937491 Enrollment ID: I20181026001066 |
| Provider Name | Willa J Feldhaus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508199688 PECOS PAC ID: 6608297452 Enrollment ID: I20200602002647 |
| Provider Name | Stephanie Boisvert Canal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255697561 PECOS PAC ID: 3274848437 Enrollment ID: I20200602002968 |
| Provider Name | Jaime Lynn Flores |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316358229 PECOS PAC ID: 0749674646 Enrollment ID: I20220218000041 |
| Provider Name | Robyn N Schroeder |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578108692 PECOS PAC ID: 2264814615 Enrollment ID: I20220801002346 |
| Provider Name | Bethany J Cobbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659913069 PECOS PAC ID: 8820465693 Enrollment ID: I20221108000792 |
| Provider Name | Brienna Lyn Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417266743 PECOS PAC ID: 3476910761 Enrollment ID: I20230531003663 |
| Provider Name | Victor R Barnes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568448041 PECOS PAC ID: 0749552669 Enrollment ID: I20230727003605 |
| Provider Name | Courtney Nicole Hull |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861120727 PECOS PAC ID: 3274904859 Enrollment ID: I20230810003471 |
| Provider Name | Gary Bruce Pate |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780238030 PECOS PAC ID: 6204299332 Enrollment ID: I20230822004337 |
| Provider Name | Courtney Cross |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528777133 PECOS PAC ID: 8628431293 Enrollment ID: I20230830000082 |
| Provider Name | Whitney Y Danso |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720611833 PECOS PAC ID: 3870907595 Enrollment ID: I20230921000559 |
| Provider Name | John L Krzich |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1710186424 PECOS PAC ID: 0345697421 Enrollment ID: I20231110001727 |
| Provider Name | Lori S Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700435401 PECOS PAC ID: 0244671410 Enrollment ID: I20240520000396 |
| Provider Name | Matrice E Morrison |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629431945 PECOS PAC ID: 8527409713 Enrollment ID: I20240520000812 |
| Provider Name | Regina M Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710302781 PECOS PAC ID: 6305388844 Enrollment ID: I20240612000168 |
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