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SOUTHLAKE PSYCHIATRY PC
NPI 1295921724
Psychiatry & Neurology - Psychiatry in Davidson, NC

Active since September 18, 2007
903 NORTHEAST DR, SUITE 301, DAVIDSON, NC 28036(704) 894-9309(704) 894-9304 Get Directions Write a Review

NPPES record last updated: August 1, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Southlake Psychiatry Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHLAKE PSYCHIATRY PC (NPI 1295921724) is a healthcare organization registered as a psychiatry in Davidson, North Carolina and active in the NPI registry since September 2007. The organization lists Thomas Michael Fitzgerald, President, as its authorized official.

NPPES Registry Identity

NPI1295921724
Entity TypeOrganization
Primary Taxonomy2084P0800X
Legal Business NameSOUTHLAKE PSYCHIATRY PC
Location Address903 NORTHEAST DR, SUITE 301Davidson, NC 28036
Mailing Address903 Northeast Dr, Suite 301Davidson, NC 28036-7416 · (704) 894-9309 · Fax (704) 894-9304
Phone(704) 894-9309
Fax(704) 894-9304
Organization SubpartNo
Authorized OfficialThomas Michael FitzgeraldPresident · (704) 894-9309
Enumeration DateSeptember 18, 2007
Last NPPES UpdateAugust 1, 2025
NPPES CertifiedAugust 1, 2025
✔ NPI 1295921724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in NC · 9300112
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
903 NORTHEAST DR, Davidson, NC 28036
Open in Google Maps ↗

Other Identifiers 2

OtherB3348NC · Bcbs
Medicaid8932269NC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BENJAMIN JAMES EPSTEIN DMSC, PA-C
Physician Assistant
903 NORTHEAST DR
DAVIDSON, NC 28036
Mecklenburg County (704) 894-9309
CARINA WISE
Marriage & Family Therapist
903 NORTHEAST DR, SUITE 201
DAVIDSON, NC 28036
Mecklenburg County (704) 896-7776
KRISTIN DESSERT KIRK L.C.S.W.
Social Worker (Clinical)
903 NORTHEAST DR, SUITE 101
DAVIDSON, NC 28036
Mecklenburg County (704) 237-0421
ALLYSE RONAE MCNEIL
Counselor (Mental Health)
903 NORTHEAST DR
DAVIDSON, NC 28036
Mecklenburg County (704) 896-7776
MR. VIRGIL J FOSTER LCSW
Social Worker (Clinical)
903 NORTHEAST DR, SUITE 102
DAVIDSON, NC 28036
Mecklenburg County (704) 641-1172
MS. LISA ANN FIRULLO LPC
Counselor (Professional)
903 NORTHEAST DR, SUITE 301
DAVIDSON, NC 28036
Mecklenburg County (704) 941-9419
CRYSTAL KELLY RN, FNP
Nurse Practitioner (Family)
903 NORTHEAST DR, SUITE 301
DAVIDSON, NC 28036
Mecklenburg County (704) 894-9309
GREAT EXPECTATIONS COUNSELING SERVICES
Counselor (Mental Health)
903 NORTHEAST DR, SUITE 101
DAVIDSON, NC 28036
Mecklenburg County (704) 724-3525

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southlake Psychiatry PC's NPI number?

The NPI number for Southlake Psychiatry PC is 1295921724. It was assigned to this organization in the NPPES registry on September 18, 2007.

Where is Southlake Psychiatry PC located?

Southlake Psychiatry PC is located at 903 Northeast Dr Suite 301, Davidson, NC 28036. The listed phone number is (704) 894-9309.

What is Southlake Psychiatry PC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

When was this NPI record last updated?

The NPPES record for Southlake Psychiatry PC was last updated on August 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.