NPIMap

Organization Active NPI

University of Toledo Psychology Clinic

  • Community/Behavioral Health Agency
  • Toledo, OH
National Provider Identifier
1407057615
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
3856 Issued in OH
Legal business name
UNIVERSITY OF TOLEDO PSYCHOLOGY CLINIC
Practice address
2801 W Bancroft St
Dept. of Psychology (Ms # 948), University of Toledo
Toledo, OH 43606-3328
Phone
(419) 530-2721
Fax
(419) 530-8479
NPI assigned
May 29, 2007
Last updated
Aug 14, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF TOLEDOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

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

Authorized official

Name
Prof. Wesley A Bullock, PH.D.NPI 1649304452
Title
Director
Phone
(419) 530-2721

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 3856 OH Primary

Addresses

Primary practice location

2801 W Bancroft St
Dept. of Psychology (Ms # 948), University of Toledo
Toledo, OH 43606-3328

Mailing address

2801 W Bancroft St
Dept. of Psychology (Ms # 948), University of Toledo
Toledo, OH 43606-3328
Phone (419) 530-2721

National Provider Directory

National Provider Directory
Tax ID family
Kinesiotherapy Ctr Univ3 organizations share this tax ID, including this one
Part of
Kinesiotherapy Ctr Univ

Other organizations with this tax ID 2

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

Locations

2801 W Bancroft St
#948
Toledo, OH 43606
Phone (419) 290-8489

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344902400000",
    "number": "1407057615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W BANCROFT ST",
            "address_2": "DEPT. OF PSYCHOLOGY (MS # 948), UNIVERSITY OF TOLEDO",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063328",
            "telephone_number": "419-530-2721",
            "fax_number": "419-530-8479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W BANCROFT ST",
            "address_2": "DEPT. OF PSYCHOLOGY (MS # 948), UNIVERSITY OF TOLEDO",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063328",
            "telephone_number": "419-530-2721",
            "fax_number": "419-530-8479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF TOLEDO PSYCHOLOGY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF TOLEDO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2012-08-14",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-530-2721",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "3856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.