| Lake Norman Psychological Services Pllc | |
|
9820 Northcross Center Ct Ste 210 Huntersville NC 28078-7356 | |
| (704) 677-2652 | |
| Not Available |
| Full Name | Lake Norman Psychological Services Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 9820 Northcross Center Ct Ste 210, Huntersville, North Carolina |
| Authorized Official Name and Position | Jennifer L Sadoff (OWNER) |
| Authorized Official Contact | 7046772652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Norman Psychological Services Pllc 9820 Northcross Center Ct Ste 210 Huntersville NC 28078-7356 Ph: (704) 677-2652 | Lake Norman Psychological Services Pllc 9820 Northcross Center Ct Ste 210 Huntersville NC 28078-7356 Ph: (704) 677-2652 |
| NPI Number | 1114665916 |
|---|---|
| Provider Enumeration Date | 05/23/2022 |
| Last Update Date | 01/29/2024 |
| Certification Date | 01/29/2024 |
| Medicare PECOS PAC ID | 2567844129 |
|---|---|
| Medicare Enrollment ID | O20220729001726 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114665916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer L Sadoff |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851332910 PECOS PAC ID: 7517903487 Enrollment ID: I20050630000424 |
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