Organization
CAROLINA PSYCH GROUP, PA
Active
Organization
CAROLINA PSYCH GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES A POWELL PSY.D. (CEO/CLINICAL PSYCHOLOGIST)
(704) 873-1697
Entity
Organization
Contact information
Practice address
515 BROOKDALE DR, STATESVILLE, NC 28677-4107
(704) 873-1697
Mailing address
515 BROOKDALE DR, STATESVILLE, NC 28677-4107
(704) 873-1697
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
633
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005112
—
NC
Enumeration date
05/17/2006
Last updated
08/22/2020
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