Clinical Neuropsychological Services, Inc.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

CLINICAL NEUROPSYCHOLOGICAL SERVICES, INC.

Practice address

1045 Mackenzie Dr
Lima, OH 45805-1660

Phone

(419) 222-5672

Fax

(419) 222-6786

NPI assigned

Mar 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Matthew P Ziccardi, PSYD

Title

Owner

Phone

(419) 222-5672

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365984000000",
    "number": "1043348600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 MACKENZIE DR",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458051660",
            "telephone_number": "419-222-5672",
            "fax_number": "419-222-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 MACKENZIE DR",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458051660",
            "telephone_number": "419-222-5672",
            "fax_number": "419-222-6786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL NEUROPSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2013-04-15",
        "status": "A",
        "authorized_official_last_name": "ZICCARDI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-222-5672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.