Shoreline Neuropsychology and Behavioral Health, LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2416 Issued in CT

Legal business name

SHORELINE NEUROPSYCHOLOGY AND BEHAVIORAL HEALTH, LLC

Practice address

173 Montowese St
Branford, CT 06405-3887

Phone

(475) 221-8108

NPI assigned

Jun 30, 2014

Organization subpart

No

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

Authorized official

Name

Amy Palmer, PSYD

Title

Neuropsychologist

Phone

(475) 221-8108

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469145600000",
    "number": "1487069241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 MONTOWESE ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053887",
            "telephone_number": "475-221-8108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 MONTOWESE ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053887",
            "telephone_number": "475-221-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE NEUROPSYCHOLOGY AND BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2016-07-22",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "475-221-8108",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "2416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Branford, CT
• Providers in Branford, CT by specialty
• Clinical Neuropsychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.