NPIMap

Organization Active NPI

Brain Lane Memory Center LLC

  • Clinical Psychologist
  • Boca Raton, FL
National Provider Identifier
1457698763
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
BRAIN LANE MEMORY CENTER LLC
Practice address
930 Parkside Cir N
Boca Raton, FL 33486-5229
Phone
(561) 732-7000
Fax
(561) 361-1021
NPI assigned
Jan 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Authorized official

Name
Dr. Steven M Essig, PSYD
Title
Owner
Phone
(561) 732-7000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

930 Parkside Cir N
Boca Raton, FL 33486-5229

Mailing address

930 Parkside Cir N
Boca Raton, FL 33486-5229
Phone (561) 732-7000

National Provider Directory

National Provider Directory

Locations

12040 S Jog Rd
Ste 8
Boynton Beach, FL 33437
Phone (561) 733-5083

1200 NW 17th Ave
Ste 12
Delray Beach, FL 33445
Phone (561) 270-2280

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1457698763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 PARKSIDE CIR N",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334865229",
            "telephone_number": "561-732-7000",
            "fax_number": "561-361-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 PARKSIDE CIR N",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334865229",
            "telephone_number": "561-732-7000",
            "fax_number": "561-361-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN LANE MEMORY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "ESSIG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-732-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

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