Provider Demographics
NPI:1922121425
Name:CHILD NEUROPSYCHOLOGY & COUNSELING CENTER, P.C.
Entity Type:Organization
Organization Name:CHILD NEUROPSYCHOLOGY & COUNSELING CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDY
Authorized Official - Middle Name:SYLVAN
Authorized Official - Last Name:POTTINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-490-5757
Mailing Address - Street 1:5232 VILLAGE CREEK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4437
Mailing Address - Country:US
Mailing Address - Phone:972-490-5757
Mailing Address - Fax:972-250-3644
Practice Address - Street 1:5232 VILLAGE CREEK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4437
Practice Address - Country:US
Practice Address - Phone:972-490-5757
Practice Address - Fax:972-250-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31374103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty