Provider Demographics
NPI:1851556609
Name:CLINICAL NEUROPSYCHOLOGY SERVICES, LLC
Entity Type:Organization
Organization Name:CLINICAL NEUROPSYCHOLOGY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:703-304-8352
Mailing Address - Street 1:200 N GLEBE RD
Mailing Address - Street 2:SUITE 1050
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-3728
Mailing Address - Country:US
Mailing Address - Phone:703-875-0475
Mailing Address - Fax:703-875-0476
Practice Address - Street 1:200 N GLEBE RD
Practice Address - Street 2:SUITE 1050
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-3728
Practice Address - Country:US
Practice Address - Phone:703-875-0475
Practice Address - Fax:703-875-0476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty