Prism Psychological Services, Pc | |
19810 W Catawba Ave Ste E Cornelius NC 28031-4057 | |
(704) 212-2020 | |
(704) 212-2020 |
Full Name | Prism Psychological Services, Pc |
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Speciality | Psychologist |
Location | 19810 W Catawba Ave Ste E, Cornelius, North Carolina |
Authorized Official Name and Position | Ronald Field (PRESIDENT) |
Authorized Official Contact | 7042122020 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Prism Psychological Services, Pc 19810 W Catawba Ave Ste E Cornelius NC 28031-4057 Ph: (704) 212-2020 | Prism Psychological Services, Pc 19810 W Catawba Ave Ste E Cornelius NC 28031-4057 Ph: (704) 212-2020 |
NPI Number | 1144747452 |
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Provider Enumeration Date | 08/28/2017 |
Last Update Date | 10/04/2018 |
Medicare PECOS PAC ID | 2769758341 |
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Medicare Enrollment ID | O20171026000775 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144747452 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 4903 (North Carolina) | Primary |
Provider Name | Ronald S Field |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1952416083 PECOS PAC ID: 2567563240 Enrollment ID: I20171026000916 |
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