Southpark Psychotherapy Pllc

NPI Registration Record

Provider / Organization	NPI	Date Certified
SOUTHPARK PSYCHOTHERAPY PLLC	1679285043	2024-11-10

The organization Southpark Psychotherapy Pllc is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1679285043. Registration indicates Southpark Psychotherapy Pllc is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Mental Health, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Mental Health, Behavioral Health & Social Service Providers) (Counselor, )

Other Names:

• SouthPark Psychotherapy

Entity Type	Organization
Provider Organization	SOUTHPARK PSYCHOTHERAPY PLLC
Other Provider Organization	SOUTHPARK PSYCHOTHERAPY
Practice Office Address	309 S SHARON AMITY RD STE 304 CHARLOTTE, NC US
Practice Office Telephone	9809990501
Mailing Address	309 S SHARON AMITY RD STE 304 CHARLOTTE, NC 282112886 US
Business Telephone	9809990501
Authorized Official	SARA ELIZABETH WILKERSON, COUNSELOR AND O 9809990501

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