Provider Demographics
NPI:1134484470
Name:NORTHWEST ASSOCIATES PSYCHOLOGICAL LLC
Entity Type:Organization
Organization Name:NORTHWEST ASSOCIATES PSYCHOLOGICAL LLC
Other - Org Name:NORTHWEST ACADEMY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPPUIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:775-372-1199
Mailing Address - Street 1:1472 S HIGHWAY 373
Mailing Address - Street 2:HCR 70 BOX 531
Mailing Address - City:AMARGOSA VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89020-1514
Mailing Address - Country:US
Mailing Address - Phone:775-372-1199
Mailing Address - Fax:775-372-1196
Practice Address - Street 1:1472 S HIGHWAY 373
Practice Address - Street 2:HCR 70 BOX 531
Practice Address - City:AMARGOSA VALLEY
Practice Address - State:NV
Practice Address - Zip Code:89020-1514
Practice Address - Country:US
Practice Address - Phone:775-372-1199
Practice Address - Fax:775-372-1196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty