Organization Name: | HEALTH CARE PSYCHOLOGY, PA |
NPI Number: | 1356586457 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STANLEY C FERNEYHOUGH (PRESIDENT) |
Mailing Address: | 20 Lake St N Suite 320 Forest Lake |
State: | MN US |
Postal Code: | 550252523 |
Phone Number: | 6514646900 |
Fax Number: | 6514646333 |
NPI Enumeration Date: | 12/04/2008 |
NPI Last Update Date: | 12/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | LP1901 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |