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BLACK MOUNTAIN NEUROPSYCHOLOGY PLLC NPI 1548675077


NPI Information

NPI: 1548675077
Provider Name: BLACK MOUNTAIN NEUROPSYCHOLOGY, PLLC
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Organization
Address:
33755 N SCOTTSDALE RD
SUITE J105
SCOTTSDALE, AZ
ZIP 85266
Phone: (480) 575-5700
Get Directions

BLACK MOUNTAIN NEUROPSYCHOLOGY, PLLC is a clinical neuropsychologist in Scottsdale, AZ. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. BLACK MOUNTAIN NEUROPSYCHOLOGY, PLLC NPI is 1548675077. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

33755 N SCOTTSDALE RD
SUITE J105
SCOTTSDALE, AZ
ZIP 85266-567
Phone: (480) 575-5700
Fax: (866) 307-0007

The provider's authorized official is Konstantinos D Thomopoulos .
The authorized official title is Member and has the following contact phone number (480) 575-5700.

The enumeration date for this NPI number is 6/23/2014 and was last updated on 6/23/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103T00000XPsychologistNo
2103TA0400XPsychologistAddiction (Substance Use Disorder)No
3103TA0700XPsychologistAdult Development & AgingNo
4103TB0200XPsychologistCognitive & BehavioralNo
5103TC0700XPsychologistClinicalNo
6103TC2200XPsychologistClinical Child & AdolescentNo
7103TF0000XPsychologistFamilyNo
8103TF0200XPsychologistForensicNo
9103TH0004XPsychologistHealthNo
10103TP2701XPsychologistGroup PsychotherapyNo
11103TR0400XPsychologistRehabilitationNo
12103G00000XClinical NeuropsychologistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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