Axon Psychology Group, PC
Organization Active NPI Clinical Neuropsychologist · Saint Joseph, MI
NPI 1265046098 · NPPES record last updated Dec 7, 2020
Key facts
- NPI
- 1265046098
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Neuropsychologist 103G00000X
- Legal business name
- AXON PSYCHOLOGY GROUP, PC
- Practice address
- 2500 Niles Rd Ste 5
Saint Joseph, MI 49085-3225 - Phone
- (269) 281-0408
- Fax
- (269) 281-4065
- NPI assigned
- Aug 31, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Christopher Contardo, PHD, ABPP-CN
- Title
- President
- Phone
- (617) 435-9641
Practitioners 6
-
Stephanie Merkey Slye, PSY.D.
-
Christopher Trigger, M.D.
-
Laura Flynn, PSY.D.
-
Lorena Marjorie Newkirk, MSPT
-
Patrick John Murphy, LMSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201008003029 | MI | Part B Supplier - Clinic/Group Practice | 6507286721 |
Receives reassigned benefits from 5 practitioners Practice locations: Saint Joseph, MI |
National Provider Directory
Locations
2500 Niles Rd
Ste 5
Saint Joseph, MI 49085
Phone (269) 281-0408
2500 Niles Rd
Ste 7
Saint Joseph, MI 49085
Phone (269) 281-0407
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist |
103G00000X | Yes |
Addresses
Primary practice location
2500 Niles Rd Ste 5
Saint Joseph, MI 49085-3225
Mailing address
2500 Niles Rd Ste 5
Saint Joseph, MI 49085-3225
Phone (269) 281-0408
Other providers in Saint Joseph, MI
- Jessica Atkins
- Corey Aukerman
- Cassandra Dawn Ault
- Julia E Austen
- Avalon Consulting, Inc.
- Margaretha Baestaens
- Bidisha Bagchi
- Kourosh Baghelai
- Abigail Jane Baker
- Alina McBride Baltazar
All providers in Saint Joseph, MI · Clinical Neuropsychologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.