Provider Demographics
NPI:1851728653
Name:CENTER FOR NEUROPSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:CENTER FOR NEUROPSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-356-0787
Mailing Address - Street 1:6008 ABERFELDY CT
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8344
Mailing Address - Country:US
Mailing Address - Phone:614-356-0787
Mailing Address - Fax:
Practice Address - Street 1:6008 ABERFELDY CT
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8344
Practice Address - Country:US
Practice Address - Phone:614-356-0787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-11
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty