Provider Demographics
NPI:1396414108
Name:SUMMIT NEUROPSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:SUMMIT NEUROPSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-420-7075
Mailing Address - Street 1:7720 S BROADWAY STE 570
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2636
Mailing Address - Country:US
Mailing Address - Phone:720-242-7533
Mailing Address - Fax:
Practice Address - Street 1:3000 CENTER GREEN DR STE 230
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2364
Practice Address - Country:US
Practice Address - Phone:720-242-7533
Practice Address - Fax:720-815-2613
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT NEUROPSYCHOLOGICAL SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty