Provider Demographics
NPI:1770787855
Name:NEUROPSYCH ASSOCIATES LLC
Entity type:Organization
Organization Name:NEUROPSYCH ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GILRAIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:609-206-1901
Mailing Address - Street 1:739 S WHITE HORSE PIKE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1659
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:856-546-2301
Practice Address - Street 1:739 S WHITE HORSE PIKE
Practice Address - Street 2:SUITE 2
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1659
Practice Address - Country:US
Practice Address - Phone:609-206-1901
Practice Address - Fax:856-546-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016078103TC0700X
NJ35SI00445800103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty