SELF-FULL PSYCHOTHERAPY PC NPI 1710126412

NPI Information

  • NPI: 1710126412
  • Provider Name: SELF-FULL PSYCHOTHERAPY, PC
  • Classification: Community/Behavioral Health - 251S00000X
  • Entity Type: Organization
  • Address: 106 OAKLEY AVE
    SUITE 300
    PINEVILLE, NC
    ZIP 28134
  • Phone: (704) 576-3635

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NPI Details

SELF-FULL PSYCHOTHERAPY, PC is a community behavioral health in Pineville, NC. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. SELF-FULL PSYCHOTHERAPY, PC NPI is 1710126412. The provider is registered as an organization entity type.

The provider's business location address is:

106 OAKLEY AVE
SUITE 300
PINEVILLE, NC
ZIP 28134-620
Phone: (704) 576-3635
Fax: (704) 889-5649

The provider's authorized official is Dorothy Christin Luke .
The authorized official title is Owner/president and has the following contact phone number (704) 576-3635.

The enumeration date for this NPI number is 2/19/2009 and was last updated on 2/19/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthC004450NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
16002779MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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