Pediatric Neuropsychological Services, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2008011433 Issued in MO

Legal business name

PEDIATRIC NEUROPSYCHOLOGICAL SERVICES, LLC

Practice address

175 S. Marshall
Suite G
Rogersville, MO 65742

Phone

(417) 753-1963

Fax

(417) 753-9405

NPI assigned

Aug 29, 2012

Last updated

Aug 29, 2012By 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. Dawn H Huber, PHDNPI 1366694937

Title

Managing Member

Phone

(417) 753-1963

Specialties & licenses 6

Addresses

Locations

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.

• Dawn Heather Huber, PHD

  • Clinical Child & Adolescent Psychologist
  • Columbia, MO
  • NPI 1366694937

  Clinical Neuropsychologist

  NPD (past) Authorized official

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1366790941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 S. MARSHALL",
            "address_2": "SUITE G",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "65742",
            "telephone_number": "417-753-1963",
            "fax_number": "417-753-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S. MARSHALL",
            "address_2": "SUITE G",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "65742",
            "telephone_number": "417-753-1963",
            "fax_number": "417-753-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC NEUROPSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "HUBER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "417-753-1963",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MO",
            "license": "2008011433",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2008011433",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MO",
            "license": "2008011433",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MO",
            "license": "2008011433",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MO",
            "license": "2008011433",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "MO",
            "license": "2008011433",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodore Brooke Nelson, P.T.
• Ashley M Nimmo, DPT
• Kinsey Olson, RN, BSN
• Lydia Paoni
• Madison Marie Parson, PTA
• Robert W Powers, DO
• Professional Counseling Services LLC
• Leea D Reed, DO
• Regional Services (Coxhealth School Based Telemedicine)
• Rehab Enterprises,LLC

• Psychologist in Rogersville, MO
• Providers in Rogersville, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.