Provider Demographics
NPI:1285069476
Name:UPTOWN PSYCHOLOGY
Entity type:Organization
Organization Name:UPTOWN PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-333-8861
Mailing Address - Street 1:1818 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-4790
Mailing Address - Country:US
Mailing Address - Phone:704-333-8861
Mailing Address - Fax:800-682-8178
Practice Address - Street 1:1818 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-4790
Practice Address - Country:US
Practice Address - Phone:704-333-8861
Practice Address - Fax:800-682-8178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4838101YP2500X
NCC0030401041C0700X
NCC0049811041C0700X
NCC0075171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty