# CAROLINAS MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CAROLINAS MEDICAL CENTER
- **Other names:** CMC Psychiatry and Behavioral Health
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1356689996
- **Legal business name:** CAROLINAS MEDICAL CENTER
- **Authorized official:** SCOTT RISSMILLER (ENTERPRISE EVP)
- **Authorized official phone:** (704) 355-8675

## Contact information

- **Practice address:** 501 BILLINGSLEY RD, STE B, CHARLOTTE, NC 28211-1009
- **Practice address phone:** (704) 444-2400
- **Mailing address:** PO BOX 19305, CHARLOTTE, NC 28219-9305
- **Mailing address phone:** (704) 631-0002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/16/2013
- **Last updated:** 03/09/2023