DR. JORDYNN MICHELLE FRASER PSYD
NPI 1487430542
Psychologist in Charlotte, NC

Active since September 05, 2023PECOS Enrolled
1900 RANDOLPH RD STE 1010, CHARLOTTE, NC 28207(704) 384-1390 Get Directions Write a Review

NPPES record last updated: December 11, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 11, 2024, Sep 5, 2023 (2 updates tracked since 2023).

About Dr. Jordynn Michelle Fraser Psyd NPPES

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

DR. JORDYNN MICHELLE FRASER PSYD (NPI 1487430542) is an individual psychologist in Charlotte, North Carolina, licensed in North Carolina (6700) and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Springdale.

NPPES Registry Identity

NPI1487430542
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. JORDYNN MICHELLE FRASERCredential: PSYD
Location Address1900 RANDOLPH RD STE 1010Charlotte, NC 28207-1117
Mailing AddressPo Box 60447Charlotte, NC 28260-0447
Sole ProprietorNo
Enumeration DateSeptember 5, 2023
Last NPPES UpdateDecember 11, 20242 updates tracked since enumeration
NPPES CertifiedDecember 11, 2024
NPI 1487430542 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Licenses Licensed in NC · 6700 Licensed in AR · 202246
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

1900 RANDOLPH RD STE 1010, Charlotte, NC 28207

Secondary Practice Location 1

Location 12575 Gene George BlvdSpringdale, AR 72762-6385 · Phone (479) 750-0125

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Jordynn Michelle Fraser Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 10

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

Licensed Practical Nurse
1900 RANDOLPH RD STE 1010
CHARLOTTE, NC 28207
Pediatrics (Sleep Medicine)
1900 RANDOLPH RD STE 1010
CHARLOTTE, NC 28207
Internal Medicine (Sleep Medicine)
1900 RANDOLPH RD STE 1010
CHARLOTTE, NC 28207
Neurological Surgery
1900 RANDOLPH RD STE 1010
CHARLOTTE, NC 28207
Nurse Practitioner
1900 RANDOLPH RD STE 1010
CHARLOTTE, NC 28207
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1900 RANDOLPH RD STE 1010
CHARLOTTE, NC 28207
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1900 RANDOLPH RD STE 1010
CHARLOTTE, NC 28207
Nurse Practitioner
1900 RANDOLPH RD STE 1010
CHARLOTTE, NC 28207

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1487430542, enumerated as an "individual" on September 05, 2023.

The provider is located at 1900 RANDOLPH RD STE 1010 CHARLOTTE, NC 28207 and the phone number is (704) 384-1390.

Psychologist with taxonomy code 103T00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of NC. Please consult your insurance carrier or call the provider to verify.