Neuropsychology Clinic

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

816 Issued in AL

Legal business name

NEUROPSYCHOLOGY CLINIC

Practice address

2804 20TH Ave
Northport, AL 35476-3835

Phone

(205) 333-1404

Fax

(205) 333-1516

NPI assigned

Nov 19, 2007

Last updated

May 5, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark L Prohaska, PHDNPI 1073663555

Title

Director

Phone

(205) 344-6169

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Linden Prohaska, PH.D.

  • Clinical Neuropsychologist
  • Tuscaloosa, AL
  • NPI 1073663555
  NPD (past) Authorized official
• Henry Randall Griffith, PHD

  • Clinical Neuropsychologist
  • Vestavia, AL
  • NPI 1891703054
  NPD (past)
• Kristine Lee Lokken, PHD

  • Clinical Neuropsychologist
  • Birmingham, AL
  • NPI 1548290984
  NPD (past)
• Delisa Arlinda West, PHD

  • Clinical Psychologist
  • Birmingham, AL
  • NPI 1376567420
  NPD (past)
• Susan D Gierok, PHD

  • Clinical Neuropsychologist
  • West Palm Beach, FL
  • NPI 1669652657
  NPD (past)

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273017600000",
    "number": "1093996985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 20TH AVE",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763835",
            "telephone_number": "205-333-1404",
            "fax_number": "205-333-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 20TH AVE",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763835",
            "telephone_number": "205-333-1404",
            "fax_number": "205-333-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPSYCHOLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2010-05-05",
        "status": "A",
        "authorized_official_last_name": "PROHASKA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "205-344-6169",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AL",
            "license": "816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51504930",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne C Myers, M.D.
• Olivia P Nagus
• Richard Navickas II
• Ashley Marie Neuhauser, LPC
• Neurology Clinic, P.C.
• New Beacon Healthcare Group, LLC (New Beacon of Jasper)
• Seth Peyton Nicholas
• Alicia O Nichols, CRNP
• Julie Beth Nicholson, LPTA
• Tameka Chardell Noland, FNP-C

• Clinical Neuropsychologist in Northport, AL
• Providers in Northport, AL by specialty
• Clinical Neuropsychologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.