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9820 Northcross Center Ct Ste 210 Huntersville NC 28078-7356 | |
(704) 677-2652 | |
Not Available |
Full Name | |
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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 |
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9820 Northcross Center Ct Ste 210 Huntersville NC 28078-7356 Ph: (704) 677-2652 | 9820 Northcross Center Ct Ste 210 Huntersville NC 28078-7356 Ph: (704) 677-2652 |
NPI Number | 1114665916 |
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Provider Enumeration Date | 05/23/2022 |
Last Update Date | 01/29/2024 |
Certification Date | 01/29/2024 |
Medicare PECOS PAC ID | 2567844129 |
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Medicare Enrollment ID | O20220729001726 |
Identifier | Type | State | Issuer |
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1114665916 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Jennifer L Sadoff |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1851332910 PECOS PAC ID: 7517903487 Enrollment ID: I20050630000424 |
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