Organization Active NPI

Mindful Neuropsychological Services, PC

  • Clinical Neuropsychologist
  • Bryn Mawr, PA
National Provider Identifier
1164995023
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
MINDFUL NEUROPSYCHOLOGICAL SERVICES, PC
Practice address
940 E Haverford Rd Ste 303
Bryn Mawr, PA 19010-3859
Phone
(215) 910-3652
NPI assigned
Jan 3, 2019
Last updated
Jan 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Authorized official

Name
Neha K Dixit, PH.D.NPI 1053621623
Title
Clinical Neuropsychologist
Phone
(215) 910-3652

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X NU Primary

Addresses

Primary practice location

940 E Haverford Rd Ste 303
Bryn Mawr, PA 19010-3859

Mailing address

1349 Indian Creek Dr
Wynnewood, PA 19096-3321
Phone (352) 682-3655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190201000075 PA Part B Supplier - Clinic/Group Practice 6002153863 Receives reassigned benefits from 2 practitioners
Practice locations: Bryn Mawr, PA

National Provider Directory

National Provider Directory

Locations

940 E Haverford Rd
Ste 303
Bryn Mawr, PA 19010
Phone (215) 910-3652

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546473600000",
    "number": "1164995023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1349 INDIAN CREEK DR",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963321",
            "telephone_number": "352-682-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 E HAVERFORD RD STE 303",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103859",
            "telephone_number": "215-910-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL NEUROPSYCHOLOGICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-01-03",
        "status": "A",
        "authorized_official_last_name": "DIXIT",
        "authorized_official_first_name": "NEHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CLINICAL NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "215-910-3652",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.