Black Sand Neuropsychological Services, Inc.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

BLACK SAND NEUROPSYCHOLOGICAL SERVICES, INC.

Practice address

25 Kahoa St
Hilo, HI 96720-2205

Phone

(808) 345-1726

NPI assigned

Apr 2, 2020

Last updated

Apr 2, 2020By 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

Dr. Lorraine Razzi Freedle, LCSW, PHDNPI 1881790590

Title

President

Phone

(808) 345-1726

Specialties & licenses 1

Addresses

Other names 1

• Black Sand Neuropsychological Services, PC Former legal business name

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.

• Lorraine R Freedle, PH.D, LISW

  • Clinical Psychologist
  • Hilo, HI
  • NPI 1881790590

  Clinical Neuropsychologist

  NPD Authorized official

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585785600000",
    "number": "1275162281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4249",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967200249",
            "telephone_number": "808-345-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 KAHOA ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202205",
            "telephone_number": "808-345-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK SAND NEUROPSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-02",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A",
        "authorized_official_last_name": "FREEDLE",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_middle_name": "RAZZI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-345-1726",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCSW, PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Black Sand Neuropsychological Services, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Big Island Substance Abuse Council
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• Big Isle Smile Inc.
• William Romeo Bishop Jr.
• Volynne Bixler
• Bonnie Blair
• Dieter H Blattler, H.I.S.
• Jenny Bleecker
• Heather Nicole Blodgett, LCSW
• Alley Blom

• Clinical Neuropsychologist in Hilo, HI
• Providers in Hilo, HI by specialty
• Clinical Neuropsychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.