Provider Demographics
NPI:1508885302
Name:POSTON, JENNY N (PHD)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:N
Last Name:POSTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 E 7TH ST STE 7
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2455
Mailing Address - Country:US
Mailing Address - Phone:704-964-3696
Mailing Address - Fax:980-207-3389
Practice Address - Street 1:1501 E 7TH ST STE 7
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2455
Practice Address - Country:US
Practice Address - Phone:704-964-3696
Practice Address - Fax:980-207-3389
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2245103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1068POtherBCBS
NC1068POtherBCBS
NC6107300Medicaid