Peak Neurotraining Solutions, Inc

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

0810003784 Issued in VA

Legal business name

PEAK NEUROTRAINING SOLUTIONS, INC

Practice address

107 E Holly Ave
Suite 13
Sterling, VA 20164-5405

Phone

(703) 444-7325

Fax

(703) 444-7325

NPI assigned

Oct 18, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Donald Richard Durousseau

Title

Executive Director

Phone

(703) 606-0670

Specialties & licenses 1

Addresses

Other names 1

• PEAK NT Doing business as

Locations

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382054400000",
    "number": "1265860787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E HOLLY AVE",
            "address_2": "SUITE 13",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201645405",
            "telephone_number": "703-444-7325",
            "fax_number": "703-444-7325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E HOLLY AVE",
            "address_2": "SUITE 13",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201645405",
            "telephone_number": "703-444-7325",
            "fax_number": "703-444-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK NEUROTRAINING SOLUTIONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-18",
        "last_updated": "2013-10-18",
        "status": "A",
        "authorized_official_last_name": "DUROUSSEAU",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "703-606-0670",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810003784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEAK NT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Corinne Ann Pauley
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• Brian Pawlicki, PHARMD
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• Clinical Neuropsychologist in Sterling, VA
• Providers in Sterling, VA by specialty
• Clinical Neuropsychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; 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.