Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
SEASIDE PSYCHOLOGICAL ASSESSMENTS AND RESOURCES FOR KIDS PLLC
Active
Organization
SEASIDE PSYCHOLOGICAL ASSESSMENTS AND RESOURCES FOR KIDS PLLC
Active
Other names
SPARKids
Organization subpart
No
Provider details
NPI number
Authorized official
TIA CORNWALL ED.S., LPA (PARTNER)
(540) 314-0606
Entity
Organization
Contact information
Practice address
4902 MAIN ST STE D, SHALLOTTE, NC 28470-4749
(910) 754-2289
Mailing address
PO BOX 1023, SHALLOTTE, NC 28459-1023
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
NULL
103T00000X
Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
10/20/2025
Last updated
08/10/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers