Cornerstone Neuropsychology, LLC

Organization Active NPI Clinical Psychologist · Shalimar, FL

NPI 1245675784 · NPPES record last updated May 9, 2013

Key facts

NPI
1245675784
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Psychologist 103TC0700X
License
PY7940 (FL)
Legal business name
CORNERSTONE NEUROPSYCHOLOGY, LLC
Practice address
1270 Eglin Pkwy
Suite C-12
Shalimar, FL 32579-2306
Phone
(850) 613-6677
Fax
(850) 613-6993
NPI assigned
May 9, 2013
Organization subpart
No

Authorized official

Name
Dr. Randi Nichols McDonald, PSY.D.
Title
Owner
Phone
(850) 613-6677

National Provider Directory

Locations

1270 N Eglin Pkwy
Ste C12
Shalimar, FL 32579
Phone (850) 582-2218

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
103G00000X PY7940 FL
Psychologist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
103T00000X PY7940 FL
Cognitive & Behavioral Psychologist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
103TB0200X PY7940 FL
Clinical Psychologist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
103TC0700X PY7940 FL Yes
Forensic Psychologist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
103TF0200X PY7940 FL
Intellectual & Developmental Disabilities Psychologist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
103TM1800X PY7940 FL

Addresses

Primary practice location

1270 Eglin Pkwy
Suite C-12
Shalimar, FL 32579-2306

Mailing address

1270 Eglin Pkwy
Suite C-12
Shalimar, FL 32579-2306
Phone (850) 613-6677

Other providers in Shalimar, FL

All providers in Shalimar, FL · Clinical Psychologist in Florida

Sources for this page

Verify at the official NPI Registry.