LAKE NORMAN PSYCHIATRY & COUNSELING, PLLC (NPI# 1568674752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568674752 |
| Entity Type | Organization |
| Organization Name | LAKE NORMAN PSYCHIATRY & COUNSELING, PLLC |
| Practice Address |
116 South Main Street Suite 205 Mooresville NC 28115-0900 |
| Mailing Address |
116 South Main Street Suite 205 Po Box 900 Mooresville NC 28115-0900 |
| Practice Telephone | 7046623270 |
| Practice Fax Number | 7046623288 |
| Mailing Telephone | 7046623270 |
| Mailing Fax Number | 7046623288 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOHN EDWARD LATZ JR. (MEMBER MANAGER) |
| Authorized Official Telephone | 7046623200 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0015X |
Psychiatry & Neurology Specialization: Psychosomatic Medicine |
35688 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS GROUP NUMBER | 0276R | 01 |
| NC | 890276R | 05 |
| Street Address |
116 SOUTH MAIN STREET SUITE 205 |
| City | MOORESVILLE |
| State | NC |
| Zip Code | 28115-0900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376172338 | Shawn Booth | Counselor | 111 Laporte Lane, Mooresville, NC 28115 | 2020-04-02 |
| 1407418262 | Carlyn Jean Malenfant | Dentist | Loveland Dental Group of Mooresville, 134 N. Magnolia Street, Mooresville, NC 28115 | 2019-07-02 |
| 1619435906 | Loveland Dental Group of Mooresville | Dentist | 134 N. Magnolia Street, Mooresville, NC 28115 | 2019-03-06 |
| 1801317383 | Jessie Watts Gogg | Social Worker | 138 Shepherd Rd, Mooresville, NC 28115 | 2017-07-05 |
| 1063869469 | Amber Hicks-thibodeau | Family Medicine | 798 Oak Ridge Farm Hwy. Suite A, Mooresville, NC 28115 | 2016-05-16 |
| 1003286774 | Lauren Holscher | Speech-Language Pathologist | 3369 Deal Rd, Mooresville, NC 28115 | 2015-10-06 |
| 1629460217 | Jenny S Ryerson | Social Worker | 919 N Main St Ste B, Mooresville, NC 28115 | 2015-02-19 |
| 1720495435 | Lindsey Gardner | Pharmacist | 966 E Iredell Ave., Mooresville, NC 28115 | 2014-07-14 |
| 1568899169 | Saloni Mehta | Physical Therapist | 550 Glenwood Drive, Genesis Rehab, Charlotte, NC 28115 | 2013-09-27 |
| 1528312600 | Ronnie G. Davidson II Dmd Pa | Dentist | 134 N. Magnolia St., Mooresville, NC 28115 | 2012-10-29 |
| Find all providers in zip 28115 | ||||
| Taxonomy Code | 2084P0015X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychosomatic Medicine |
| Psychosomatic Medicine is subspecialty in the diagnosis and treatment of psychiatric disorders and symptoms in complex medically ill patients. This subspecialty includes treatment of patients with acute or chronic medical, neurological, obstetrical or surgical illness in which psychiatric illness is affecting their medical care and/or quality of life such as HIV infection, organ transplantation, heart disease, renal failure, cancer, stroke, traumatic brain injury, high-risk pregnancy and COPD, among others. Patients also may be those who have a psychiatric disorder that is the direct consequence of a primary medical condition, or a somatoform disorder or psychological factors affecting a general medical condition. Psychiatrists specializing in Psychosomatic Medicine provide consultation-liaison services in general medical hospitals, attend on medical psychiatry inpatient units, and provide collaborative care in primary care and other outpatient settings. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376761866 | Jean Ann Hamilton | Psychiatry & Neurology | 2741 Campus Walk Ave, Bldg 500, Ste 110, Durham, NC 27705 | 2007-04-23 |
| 1215346440 | Center Fo Emotional Health | Psychiatry & Neurology | 280 Executive Park Dr, Suite 100, Concord, NC 28025-1837 | 2014-08-13 |
| 1700069150 | Allied Psychophysiology Services Pllc | Psychiatry & Neurology | 2018 Eastwood Rd, Wilmington, NC 28403-7228 | 2007-12-07 |
| 1477748747 | David B Durham Md PC | Psychiatry & Neurology | 1236 Huffman Mill Rd, Suite 2450, Burlington, NC 27215-8700 | 2007-09-11 |
| 1235347352 | Marlene M Brogan | Psychiatry & Neurology | 4005 Oleander Dr, Wilmington, NC 28403-6816 | 2007-05-21 |
| 1518179852 | Elizabeth A Coleman | Psychiatry & Neurology | 313 Walnut St, Suite 104, Wilmington, NC 28401-4067 | 2007-05-07 |
| 1932311339 | Alexandra Newlin Powell | Psychiatry & Neurology | 2020 W Main St, Suite #20, Durham, NC 27705-4683 | 2007-05-06 |
| City | MOORESVILLE |
| Zip Code | 28115 |
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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.