Provider Demographics
NPI:1235184813
Name:HEALTH-PRO MENTAL HEALTH SERVICES PLLC
Entity Type:Organization
Organization Name:HEALTH-PRO MENTAL HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-248-2820
Mailing Address - Street 1:6700 FAIRVIEW RD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3324
Mailing Address - Country:US
Mailing Address - Phone:704-248-2820
Mailing Address - Fax:919-882-9135
Practice Address - Street 1:6700 FAIRVIEW RD
Practice Address - Street 2:SUITE 420
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3324
Practice Address - Country:US
Practice Address - Phone:704-248-2820
Practice Address - Fax:919-882-9135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97007672084P0800X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89013HPMedicaid
DE9089OtherRAILROAD MEDICARE
NC013HPOtherBCBS
NC89013HPMedicaid
NC013HPOtherBCBS