Provider Demographics
NPI:1619042538
Name:MUMPOWER, R. CARL III (PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:R.
Middle Name:CARL
Last Name:MUMPOWER
Suffix:III
Gender:M
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE OAK PLAZA
Mailing Address - Street 2:STE. 309
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801
Mailing Address - Country:US
Mailing Address - Phone:828-252-8390
Mailing Address - Fax:
Practice Address - Street 1:1 OAK PLZ
Practice Address - Street 2:STE. 309
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3008
Practice Address - Country:US
Practice Address - Phone:828-252-8390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1394103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000117Medicaid
NC6000117Medicaid