NPIMap

Organization Active NPI

Center for Psychological and Educational Assessment

  • Psychologist
  • Grand Forks, ND
National Provider Identifier
1326242702
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
231 Issued in ND
Legal business name
CENTER FOR PSYCHOLOGICAL AND EDUCATIONAL ASSESSMENT
Practice address
290 Centennial Dr Stop 7108
210 Montgomery Hall
Grand Forks, ND 58202-6063
Phone
(701) 777-3260
Fax
(701) 777-3454
NPI assigned
Jun 12, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas Victor Petros, PH.D.
Title
Professor of Psychology
Phone
(701) 777-3260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 231 ND Primary

Addresses

Primary practice location

290 Centennial Dr Stop 7108
210 Montgomery Hall
Grand Forks, ND 58202-6063

Mailing address

290 Centennial Dr Stop 7108
210 Montgomery Hall
Grand Forks, ND 58202-6063
Phone (701) 777-3260

Other identifiers 1

IdentifierTypeStateIssuer
14870OtherNDBC BS OF ND

National Provider Directory

National Provider Directory
Tax ID family
Bismark Family Practice14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

290 Centennial Dr
Stop 7108
Grand Forks, ND 58202
Phone (701) 777-3260

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326242702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 CENTENNIAL DR STOP 7108",
            "address_2": "210 MONTGOMERY HALL",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582026063",
            "telephone_number": "701-777-3260",
            "fax_number": "701-777-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 CENTENNIAL DR STOP 7108",
            "address_2": "210 MONTGOMERY HALL",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582026063",
            "telephone_number": "701-777-3260",
            "fax_number": "701-777-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PSYCHOLOGICAL AND EDUCATIONAL ASSESSMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETROS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "PROFESSOR OF PSYCHOLOGY",
        "authorized_official_telephone_number": "701-777-3260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ND",
            "license": "231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF ND",
            "identifier": "14870",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.