Provider Demographics
NPI:1821882457
Name:CAROLINA PSYCHOLOGICAL INSTITUTE, PLLC
Entity type:Organization
Organization Name:CAROLINA PSYCHOLOGICAL INSTITUTE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUDNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:815-919-7980
Mailing Address - Street 1:13206 GREYCREST DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-7100
Mailing Address - Country:US
Mailing Address - Phone:815-919-7980
Mailing Address - Fax:
Practice Address - Street 1:10965 WINDS CROSSING DR STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-2400
Practice Address - Country:US
Practice Address - Phone:815-919-7980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty