Organization Name: | NEUROPSYCHOLOGY & COUNSELING SERVICES PA |
NPI Number: | 1588860670 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KAREN K ESTILL (OWNER) |
Mailing Address: | 101 E Maud St Tavares |
State: | FL US |
Postal Code: | 327783249 |
Phone Number: | 3522539348 |
Fax Number: | 3522539351 |
NPI Enumeration Date: | 06/25/2007 |
NPI Last Update Date: | 04/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 09/14/2007 |
NPI Reactivation Date: | 01/29/2008 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PY3993 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
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. |