Provider Demographics
NPI:1154076420
Name:BRIGHTER FUTURE NEUROPSYCHOLOGY AND THERAPY CLINIC, INC
Entity Type:Organization
Organization Name:BRIGHTER FUTURE NEUROPSYCHOLOGY AND THERAPY CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMERHAYES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:510-838-2242
Mailing Address - Street 1:1005 NORTHGATE DR STE 165
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2500
Mailing Address - Country:US
Mailing Address - Phone:510-838-2242
Mailing Address - Fax:
Practice Address - Street 1:1368 LINCOLN AVE
Practice Address - Street 2:STE 212
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-2147
Practice Address - Country:US
Practice Address - Phone:510-838-2242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty