Provider Demographics
NPI:1932420189
Name:NEUROPSYCHOLOGY ASSOCIATES LLC
Entity Type:Organization
Organization Name:NEUROPSYCHOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:1517-381-1062
Mailing Address - Street 1:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48805-0344
Mailing Address - Country:US
Mailing Address - Phone:517-381-1062
Mailing Address - Fax:517-381-5252
Practice Address - Street 1:4123 OKEMOS RD
Practice Address - Street 2:SUITE 14
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-2818
Practice Address - Country:US
Practice Address - Phone:517-381-1062
Practice Address - Fax:517-381-5252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008842103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION77060Medicare PIN