Child Psychology Testing Services PLLC

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Legal business name

CHILD PSYCHOLOGY TESTING SERVICES PLLC

Practice address

6314 19TH St W Ste 14
Fircrest, WA 98466-6223

Phone

(253) 239-2310

Fax

(253) 239-2311

NPI assigned

May 26, 2022

Last updated

May 26, 2022By 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

Stacey Park, PHDNPI 1659801173

Title

Licensed Psychologist

Phone

(253) 239-2310

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Stacey Park, PHD

  • Clinical Child & Adolescent Psychologist
  • Fircrest, WA
  • NPI 1659801173
  NPD Authorized official

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1124766357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6314 19TH ST W STE 14",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6314 19TH ST W STE 14",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666223",
            "telephone_number": "253-239-2310",
            "fax_number": "253-239-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD PSYCHOLOGY TESTING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "253-239-2310",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Ann Brownlee, PH.D
• Brittney Burt
• Jeffrey Howard Camm, DMD
• Aaron Cheng, DC
• Stuart-Shea Chick
• Sophia Christensen
• Charles Michael Clark II, LMHC
• Cognitive Growth Mental Health
• Skylar Suzanne Cole
• Lea NMN Conrad, RN

• Clinical Child & Adolescent Psychologist in Fircrest, WA
• Providers in Fircrest, WA by specialty
• Clinical Child & Adolescent Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.