Neuropsychology Assessment and Wellness, LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

071007239 Issued in IL

Legal business name

NEUROPSYCHOLOGY ASSESSMENT AND WELLNESS, LLC

Practice address

645 N Michigan Ave Ste 803
Chicago, IL 60611-5123

Phone

(312) 848-1718

NPI assigned

Nov 4, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Beth Borosh, PH.D.NPI 1508061649

Title

Clinical Psychologist

Phone

(312) 848-1718

Specialties & licenses 1

Addresses

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.

• Beth Borosh, PH.D.

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1508061649
  Authorized official Same address or phone

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

{
    "created_epoch": "1351987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1316291909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040357",
            "telephone_number": "219-926-8320",
            "fax_number": "219-926-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 N MICHIGAN AVE STE 803",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115123",
            "telephone_number": "312-848-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPSYCHOLOGY ASSESSMENT AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-04",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "BOROSH",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "312-848-1718",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071007239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Neuropsychologist in Illinois

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