Organization
CAROLINA PSYCHOLOGICAL ASSOCIATES LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN MUMPER PHD (GENERAL MANAGER)
(910) 484-4776
Entity
Organization
Contact information
Practice address
501A EXECUTIVE PL, FAYETTEVILLE, NC 28305-5121
(910) 484-4776
(910) 484-1678
Mailing address
501A EXECUTIVE PL, FAYETTEVILLE, NC 28305-5121
(910) 484-4776
(910) 484-1678
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1875
NC
103TC0700X
Clinical Psychologist
1877
NC
1041C0700X
Clinical Social Worker
C003490
NC
2084P0800X
Psychiatry Physician
95-01354
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02732
BLUE CROSS
NC
Enumeration date
01/30/2007
Last updated
01/11/2008
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