| Higher Ground Psychological Services | |
|
18151 W Catawba Ave Cornelius NC 28031 | |
| (704) 495-4435 | |
| Not Available |
| Full Name | Higher Ground Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 18151 W Catawba Ave, Cornelius, North Carolina |
| Authorized Official Name and Position | Thea Oculato Silva De Souza (OWNER) |
| Authorized Official Contact | 9175895372 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Higher Ground Psychological Services 18151 W Catawba Ave Cornelius NC 28031-5641 Ph: (704) 495-4435 | Higher Ground Psychological Services 18151 W Catawba Ave Cornelius NC 28031 Ph: (704) 495-4435 |
| NPI Number | 1770064842 |
|---|---|
| Provider Enumeration Date | 08/27/2018 |
| Last Update Date | 01/11/2019 |
| Medicare PECOS PAC ID | 4981941853 |
|---|---|
| Medicare Enrollment ID | O20190130002565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770064842 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0100X | Psychologist - Health Service | 5306 (North Carolina) | Primary |
| Provider Name | Thea O Silva De Souza |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003324336 PECOS PAC ID: 2567710098 Enrollment ID: I20180731002682 |
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