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Organization

PARKTOWNE PSYCHOLOGICAL SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARVIN BURT POSTON JR. PSY.D. (OWNER/MANAGER)
(704) 522-8490
Entity
Organization

Contact information

Practice address
1515 MOCKINGBIRD LN, SUITE 212, CHARLOTTE, NC 28209-3236
(704) 522-8490
Mailing address
1515 MOCKINGBIRD LN, SUITE 212, CHARLOTTE, NC 28209-3236
(704) 522-8490

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1746
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2345099
MEDICARE GROUP NUMBER
NC
Enumeration date
09/26/2007
Last updated
01/26/2011
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