PEDIATRIC AND FAMILY BEHAVIORAL HEALTH ACQUISITION GROUP PLLC (NPI# 1770056038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770056038 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC AND FAMILY BEHAVIORAL HEALTH ACQUISITION GROUP PLLC |
| Other Organization Name | PEDIATRIC AND FAMILY BEHAVIORAL HEALTH PLLC |
| Practice Address |
10420 Park Rd Ste 300 Charlotte NC 28210-8502 |
| Practice Telephone | 9802374766 |
| Practice Fax Number | 9804042274 |
| Mailing Telephone | 9802374766 |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2020-05-12 |
| Authorized Official Name | DR. LUIS EMILIO BETANCOURT (PARTNER) |
| Authorized Official Telephone | 7047707027 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Pediatric and Family Behavioral Health PLLC | Doing Business As Name - Organization |
| Street Address |
10420 PARK RD STE 300 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28210-8502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689920357 | Laura Harvey Nazzaro | Nurse Practitioner | 10420 Park Rd Ste 300, Charlotte, NC 28210-8502 | 2012-07-31 |
| 1467074666 | Jeffrey Samuel Woodard | Physician Assistant | 10420 Park Rd Ste 300, Charlotte, NC 28210-8502 | 2020-05-11 |
| 1659903987 | Caroline Meitzner Holloway Espanol | Counselor | 10420 Park Rd Ste 300, Charlotte, NC 28210-8502 | 2020-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952920860 | Rx Care 14 LLC | Pharmacy | 7701 Sharon Lakes Road, Suite H, Charlotte, NC 28210 | 2020-04-10 |
| 1427697622 | David Durant Dinsmore | Nurse Anesthetist, Certified Registered | Atrium Health Pineville, 10628 Park Road, Charlotte, NC 28210 | 2020-01-06 |
| 1790256964 | Tele Phys Inc | Internal Medicine | 10035 Park Center Dr., Ste 100, Charlotte, NC 28210 | 2018-12-16 |
| 1104395896 | Bridgett Williams | Behavior Technician | 7806 Andover Woods Drive, Charlotte, NC 28210 | 2018-11-26 |
| 1053880518 | Low-t Physicians Professional Association | Internal Medicine | 10430 Park Road Suite 100a, Charlotte, NC 28210 | 2018-11-14 |
| 1053895102 | Carolinas Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 7701 Sharon Lakes Blvd, Ste A., Charlotte, NC 28210 | 2018-09-24 |
| 1679066658 | Afc Urgent Care and Family Care of Wnc, Pllc | Clinic/Center | 10102 Johnston Rd, Charlotte, NC 28210 | 2018-06-13 |
| 1346777018 | Hopeway Foundation | Clinic/Center | 1717 Sharon Road West, Charlotte, NC 28210 | 2017-05-12 |
| 1891154688 | Jessie Lee Ogienko | Social Worker | 5960 Fairview Rd Ste 328, Charlotte, NC 28210 | 2016-02-22 |
| 1699151985 | Carolina Complete Psychiatry, Pllc | Physician Assistant | 5950 Fairview Road, Suite 708, Charlotte, NC 28210 | 2015-08-10 |
| Find all providers in zip 28210 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417464900 | St Lazarus Behavioral Health PC | Psychiatry & Neurology | 8401 Medical Plaza Dr Ste 355, Charlotte, NC 28262-9718 | 2018-01-05 |
| 1942666334 | Daymark Recovery Services Inc | Psychiatry & Neurology | 127 N Tryon St Unit 516, Charlotte, NC 28202-2194 | 2016-01-14 |
| 1275827990 | Erica Elise Herman | Psychiatry & Neurology | 6060 Piedmont Row Dr S Ste 500, Charlotte, NC 28287-3803 | 2011-05-31 |
| 1710162078 | Patterson Healthcare Pa | Psychiatry & Neurology | 6115 Park South Drive, Suite 130, Charlotte, NC 28210-3269 | 2008-01-07 |
| 1871786830 | Wallace Harden Smith II | Psychiatry & Neurology | 3120 Cambridge Rd, Charlotte, NC 28209-1304 | 2007-08-23 |
| 1639386014 | Odette Cianchini Valder | Psychiatry & Neurology | 413 S Sharon Amity Rd, Suite B, Charlotte, NC 28211-2865 | 2007-05-16 |
| 1265659965 | Malti Praful Mehta | Psychiatry & Neurology | 459 N Wendover Rd, Malti and P Mehta Pa, Charlotte, NC 28211 | 2007-04-20 |
| 1497877468 | Mary Mcmahan Christenbury | Psychiatry & Neurology | 2231 Thornridge Rd, Charlotte, NC 28226-6446 | 2007-04-03 |
| 1447374459 | Susan K Gillette | Psychiatry & Neurology | 3604 Hampton Manor Dr, Charlotte, NC 28226-7006 | 2007-03-16 |
| 1851445209 | Preetinder Paul Singh Brar | Psychiatry & Neurology | 8029 Corporate Center Dr Ste 200, Charlotte, NC 28226-4548 | 2007-01-23 |
| Find all providers in CHARLOTTE | ||||
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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.