DR. GEROLF ENGELSTATTER


Address: 1703 Country Club Rd, Suite 204, Jacksonville, NC 28546-6006
Phone: 9103473010

DR. GEROLF ENGELSTATTER (NPI# 1932185477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932185477
Entity Type Individual
Full Name DR. GEROLF ENGELSTATTER
Credential PHD
Practice Address 1703 Country Club Rd
Suite 204
Jacksonville
NC 28546-6006
Practice Telephone 9103473010
Practice Fax Number 9103473201
Mailing Telephone 9103473010
Mailing Fax Number 9103473201
Enumeration Date 2005-12-16
Last Update Date 2008-05-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist 1140 NC Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NC BC/BS 04581 01
NC 6000579 05

Office Location

Street Address 1703 COUNTRY CLUB RD
SUITE 204
City JACKSONVILLE
State NC
Zip Code 28546-6006

Providers in the same location

NPI Name Taxonomy Address Enumeration
1164785275 Meredith Lane Knopp Speech-Language Pathologist 1703 Country Club Rd, Suite #305, Jacksonville, NC 28546-7560 2012-06-22
1437444908 Mariann Ramsey Speech-Language Pathologist 1703 Country Club Rd, Unit #305, Jacksonville, NC 28546-6008 2011-06-13
1174846208 Joyce M. Harpe Psychologist 1703 Country Club Rd, Suite 204, Jacksonville, NC 28546-6008 2010-03-03
1437488236 Gerald Macon Davis Marriage & Family Therapist 1703 Country Club Rd, Suite 204, Jacksonville, NC 28546-6008 2009-12-08
1447489596 Deborah Ann Kalnen Psychologist 1703 Country Club Rd, Jacksonville, NC 28546-6008 2009-07-10
1467698738 Comphrensive Medical Care Psychiatry & Neurology 1703 Country Club Rd, #102, Jacksonville, NC 28546-6008 2008-12-17
1700041597 Access Behavioral Assistance Inc Case Management 1703 Country Club Rd, Suite 304, Jacksonville, NC 28546-6008 2008-07-22
1487838520 People of Potential, Inc Community/Behavioral Health 1703 Country Club Rd, Suite 305, Jacksonville, NC 28546-6008 2007-12-26
1780883439 Kelli Mcamis Whitley Psychologist 1703 Country Club Rd, Suite 204, Jacksonville, NC 28546-6008 2007-07-13
1912023623 Carl Alan Steed Psychologist 1703 Country Club Rd, Suite 204, Jacksonville, NC 28546-6008 2007-03-22
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

Providers in the same taxonomy and city

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1376144774 Jennifer Mcmanus Psychologist 4143 San Juan Ave, Jacksonville, FL 32210-3333 2020-11-03
1952927600 Lourdes Portales Dale Psychologist 580 W 8th St Fl Towerii6, Jacksonville, FL 32209-6533 2020-06-18
1114414992 David Herbert Gilliland Psychologist 2752 Canyon Falls Dr, Jacksonville, FL 32224-4841 2018-04-17
1588903777 Darrin John Kirkendall Psychologist 3901 University Blvd S Ste 203, Jacksonville, FL 32216-4389 2013-02-07
1851662969 Lisa-mae Sinclair Armbrust Psychologist 11111 San Jose Blvd Ste 70, #185, Jacksonville, FL 32223-7274 2012-01-20
1366724569 Asa Therapeutic Services, Pllc Psychologist 200 Valencia Dr Ste 128, Jacksonville, NC 28546-6313 2011-09-13
1164703047 Aegis Psychological Consulting LLC Psychologist 208 E. Rusk St., Jacksonville, TX 75766 2011-09-06
1871872762 Rebecca Tagg Psychologist 1179 Mccallister Rd, Jacksonville, NC 28540-8796 2011-08-09
1942597901 Nancy Ghali Psychologist 4006 Henderson Dr., Jacksonville, NC 28546 2011-06-28
1457689911 Leslie Herbert Krieger Psychologist 3834 Reedpond Dr S, Jacksonville, FL 32223-4820 2009-11-21
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Competitor

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City JACKSONVILLE
Zip Code 28546

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Dataset Information

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.

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