BAY AREA NEUROPSYCHOLOGY, LLC

Provider Demographics

• NPI: 1790023851
• Name: BAY AREA NEUROPSYCHOLOGY, LLC
• Entity Type: Organization
• Organization Name: BAY AREA NEUROPSYCHOLOGY, LLC
• Authorized Official - Title/Position: CEO/NEUROPSYCHOLOGIST
• Authorized Official - Prefix: DR
• Authorized Official - First Name: LAMAR
• Authorized Official - Middle Name: J
• Authorized Official - Last Name: INGULLI
• Authorized Official - Credentials: PSYD
• Authorized Official - Phone: 813-381-5200
• Mailing Address - Street 1: 2919 W SWANN AVE STE 201
• Mailing Address - City: TAMPA
• Mailing Address - State: FL
• Mailing Address - Zip Code: 33609-4050
• Mailing Address - Country: US
• Mailing Address - Phone: 813-381-5200
• Mailing Address - Fax: 813-381-5200
• Practice Address - Street 1: 2919 W SWANN AVE STE 201
• Practice Address - City: TAMPA
• Practice Address - State: FL
• Practice Address - Zip Code: 33609-4050
• Practice Address - Country: US
• Practice Address - Phone: 813-381-5200
• Practice Address - Fax: 813-381-5200
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2013-01-24
• Last Update Date: 2021-10-25

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	103T00000X	Behavioral Health & Social Service Providers	Psychologist		Group - Multi-Specialty
No	101Y00000X	Behavioral Health & Social Service Providers	Counselor		Group - Multi-Specialty
No	103G00000X	Behavioral Health & Social Service Providers	Clinical Neuropsychologist		Group - Multi-Specialty
No	103TC0700X	Behavioral Health & Social Service Providers	Psychologist	Clinical	Group - Multi-Specialty
No	103TC2200X	Behavioral Health & Social Service Providers	Psychologist	Clinical Child & Adolescent	Group - Multi-Specialty
No	103TF0200X	Behavioral Health & Social Service Providers	Psychologist	Forensic	Group - Multi-Specialty
No	103TM1800X	Behavioral Health & Social Service Providers	Psychologist	Intellectual & Developmental Disabilities	Group - Multi-Specialty