Organization
PSYCHOLOGICAL SERVICES OF CHARLOTTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN RONALD MONTELEONE PH. D. (PRESIDENT)
(704) 503-3535
Entity
Organization
Contact information
Practice address
1923 J N PEASE PL, SUITE 204, CHARLOTTE, NC 28262-4513
(704) 503-3535
(704) 593-5555
Mailing address
1923 J N PEASE PL, SUITE 204, CHARLOTTE, NC 28262-4513
(704) 503-3535
(704) 593-5555
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
12226
NC
101YP2500X
Professional Counselor
3328NCLPC
NC
103T00000X
Psychologist
Primary
2846
NC
103T00000X
Psychologist
3660
NC
103T00000X
Psychologist
3953
NC
103T00000X
Psychologist
4444
NC
1041C0700X
Clinical Social Worker
C004544
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017TA
BCBS
NC
01
—
7496772
AETNA
NC
Enumeration date
07/08/2006
Last updated
05/15/2020
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