Provider Demographics
NPI:1447209051
Name:NEUROPSYCHOLOGY ASSOCIATES PLC
Entity Type:Organization
Organization Name:NEUROPSYCHOLOGY ASSOCIATES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEWANDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:269-375-2222
Mailing Address - Street 1:4328 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-5823
Mailing Address - Country:US
Mailing Address - Phone:269-375-2222
Mailing Address - Fax:269-375-6078
Practice Address - Street 1:4328 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-5823
Practice Address - Country:US
Practice Address - Phone:269-375-2222
Practice Address - Fax:269-375-6078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0C96409OtherBCBSM
MI0C96409OtherBCBSM