Provider Demographics
NPI:1750057972
Name:SILVERLEAF NEUROPSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:SILVERLEAF NEUROPSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHANEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:602-492-2372
Mailing Address - Street 1:2718 E BIGHORN AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-8984
Mailing Address - Country:US
Mailing Address - Phone:602-492-2372
Mailing Address - Fax:
Practice Address - Street 1:1110 E MISSOURI AVE STE 640
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2735
Practice Address - Country:US
Practice Address - Phone:602-492-2372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty