State of Mind Neuropsychology LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

STATE OF MIND NEUROPSYCHOLOGY LLC

Practice address

2714 Memorial Blvd
Connellsville, PA 15425-1406

Phone

(724) 317-1647

NPI assigned

Jan 11, 2022

Last updated

Jan 11, 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

Alicia Helene Puskar, PSY.DNPI 1659613842

Title

Owner/Neuropsychologist

Phone

(724) 317-1647

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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.

• Alicia H Puskar, PSY.D.

  • Clinical Neuropsychologist
  • Pittsburgh, PA
  • NPI 1659613842
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641859200000",
    "number": "1174274120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 420",
            "city": "PERRYOPOLIS",
            "state": "PA",
            "postal_code": "154730420",
            "telephone_number": "724-317-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2714 MEMORIAL BLVD",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154251406",
            "telephone_number": "724-317-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MIND NEUROPSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "PUSKAR",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "HELENE",
        "authorized_official_title_or_position": "OWNER/NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "724-317-1647",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Softa
• Marissa Soisson, O.D.
• Katrina Renee Spangler
• Edward S Spotts Jr., D.M.D.
• Lakota Stark
• Virginia Stauffer
• Jennifer Haky Sterbutzel, CRNP
• Carole Gene Stern, M.S., R.N.C.
• Chelsey Leigh Stern, PHARMD
• Jay Steven Stern, R.PH.

• Clinical Neuropsychologist in Connellsville, PA
• Providers in Connellsville, PA by specialty
• Clinical Neuropsychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.