Provider Demographics
NPI:1629271242
Name:CAREER EDUCATION PSYCHOLOGICAL EVALUATINOS
Entity Type:Organization
Organization Name:CAREER EDUCATION PSYCHOLOGICAL EVALUATINOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH ANN
Authorized Official - Middle Name:RIPPERE
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:MA & CAS
Authorized Official - Phone:910-232-2743
Mailing Address - Street 1:4425 RANDOLPH RD
Mailing Address - Street 2:SUITE 411
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2351
Mailing Address - Country:US
Mailing Address - Phone:704-362-1942
Mailing Address - Fax:704-362-1170
Practice Address - Street 1:4425 RANDOLPH RD
Practice Address - Street 2:SUITE 411
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2351
Practice Address - Country:US
Practice Address - Phone:704-362-1942
Practice Address - Fax:704-362-1170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC679103T00000X, 103TA0400X, 103TA0700X, 103TB0200X, 103TC0700X, 103TF0000X, 103TH0004X, 103TP2701X, 103TS0200X
103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Single Specialty
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty
Not Answered103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Single Specialty
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty