Provider Demographics
NPI:1770818684
Name:THE NEUROASSESSMENT CENTRE, LLC
Entity Type:Organization
Organization Name:THE NEUROASSESSMENT CENTRE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DROZD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:719-487-7943
Mailing Address - Street 1:6197 LEHMAN DR STE 105
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3446
Mailing Address - Country:US
Mailing Address - Phone:719-487-7943
Mailing Address - Fax:877-321-4010
Practice Address - Street 1:6197 LEHMAN DR STE 105
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3446
Practice Address - Country:US
Practice Address - Phone:719-487-7943
Practice Address - Fax:877-321-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2529103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty