DR. JESSICA GROLEAU (NPI# 1164947768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164947768 |
Entity Type | Individual |
Full Name | DR. JESSICA GROLEAU |
Credential | PH.D. |
Practice Address |
9201 University City Blvd Charlotte NC 28223-0001 |
Mailing Address |
421 Grantchester Cir Charlotte NC 28262-0431 |
Practice Telephone | 7046870328 |
Practice Fax Number | 6034556338 |
Mailing Telephone | 6034556338 |
Enumeration Date | 2017-08-04 |
Last Update Date | 2017-08-04 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
5027 | NC | Behavioral Health & Social Service Providers |
Street Address |
9201 UNIVERSITY CITY BLVD |
City | CHARLOTTE |
State | NC |
Zip Code | 28223-0001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508820614 | Abbey Thomas | Specialist/Technologist | 9201 University City Blvd, Belk 231, Charlotte, NC 28223 | 2006-04-14 |
1558968792 | Katrina Trinidad Gallo | Specialist/Technologist | 9201 University City Blvd, Charlotte, NC 28223-0001 | 2020-10-01 |
1043817281 | Robert Eachus | Specialist/Technologist | 9201 University City Blvd, Charlotte, NC 28223-0001 | 2020-10-01 |
1205440450 | University of North Carolina At Charlotte | Clinical Medical Laboratory | 9201 University City Blvd, Cameron 271, Charlotte, NC 28223-0001 | 2020-09-04 |
1568096089 | Shelley Linens | Specialist/Technologist | 9201 University City Blvd, Charlotte, NC 28223-0001 | 2020-02-24 |
1053943290 | Luke Donovan | Specialist/Technologist | 9201 University City Blvd, Charlotte, NC 28223-0001 | 2020-02-05 |
1972158129 | Tricia Turner | Specialist/Technologist | 9201 University City Blvd, Charlotte, NC 28223-0002 | 2019-08-05 |
1427402890 | Christopher Rogers | Pharmacist | 9201 University City Blvd, Charlotte, NC 28223-0001 | 2016-04-21 |
1740689884 | Tracy Beyer | Specialist/Technologist | 9201 University City Blvd, Charlotte, NC 28223-0001 | 2014-08-14 |
1912244369 | Alysen Janae Wallace | Counselor | 9201 University City Blvd, Charlotte, NC 28223-0001 | 2013-01-04 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306450887 | Brocker Health Center/ Unc Charlotte | Clinic/Center | 9201 University City Blvd Student Health Center, Charlotte, NC 28223-0001 | 2020-09-02 |
1427520485 | Rebeca Coletti | Behavior Technician | 8939 Cameron Blvd, Charlotte, NC 28223-0001 | 2018-12-31 |
1407240872 | Linda Probst | Specialist/Technologist | Department of Kinesiology, 9201 University City Blvd, Charlotte, NC 28223-0001 | 2015-03-24 |
1255626578 | Lydia Boldt Smith | Counselor | 9201 University City Blvd., Counseling, Charlotte, NC 28223-0001 | 2011-06-15 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770123531 | Robert B Stroker | Psychologist | 10617 Kettering Dr Ste 213, Charlotte, NC 28226-4900 | 2020-01-09 |
1902460744 | Holly Hauser | Psychologist | 1905 J N Pease Pl Ste 104, Charlotte, NC 28262-4509 | 2019-04-26 |
1972944759 | Intrusted Care Solutions Inc | Psychologist | 2340 N Graham St Ste B, Charlotte, NC 28206-2506 | 2013-07-09 |
1790029791 | David E Mermelstein | Psychologist | 6201 Fairview Road, Ste 200, Charlotte, NC 28210-3297 | 2012-11-15 |
1598014011 | Jesse Selkin | Psychologist | 8832 Blakeney Professional Dr Ste 105, Charlotte, NC 28277-6717 | 2012-08-30 |
1629324975 | Kevin L Gyoerkoe | Psychologist | 8832 Blakeney Professional Dr, Suite 105, Charlotte, NC 28277-6809 | 2012-07-24 |
1235406109 | Redlak Recovery Center, Pllc | Psychologist | 10801 Johnston Rd Ste 217, Charlotte, NC 28226-7856 | 2011-11-21 |
1801172051 | Chad Wesley Kraska | Psychologist | 7400 Carmel Executive Park Dr Ste 135, Charlotte, NC 28226-8400 | 2011-11-01 |
1679805717 | Rose Marie Leday | Psychologist | 3440 Toringdon Way, Suite #205, Charlotte, NC 28277-3190 | 2010-01-29 |
1023241965 | Briana Melissa Webber-lind | Psychologist | 12815 Longstraw Rd, Charlotte, NC 28227-3686 | 2009-08-26 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.