Organization
MECKLENBURG PSYCHOLOGICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN T WHEELER PHD (PRESIDENT)
(704) 376-6577
Entity
Organization
Contact information
Practice address
1132 GREENWOOD CLFS, CHARLOTTE, NC 28204-2821
(704) 376-6577
(704) 335-8941
Mailing address
1132 GREENWOOD CLFS, CHARLOTTE, NC 28204-2821
(704) 376-6577
(704) 335-8941
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0246H
BLUE CROSS BLUE SHIELD #
NC
Enumeration date
11/13/2006
Last updated
08/22/2020
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