Northern New Mexico Neuropsychology LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

1183 Issued in NM

Legal business name

NORTHERN NEW MEXICO NEUROPSYCHOLOGY LLC

Practice address

1911 5TH St Ste 211
Santa Fe, NM 87505-5403

Phone

(505) 490-9049

NPI assigned

Apr 3, 2012

Organization subpart

No

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

Authorized official

Name

Lauren Parks, PHD

Title

Director

Phone

(505) 490-9049

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Natalia Carr Moss, PH.D.

  • Clinical Neuropsychologist
  • Santa Fe, NM
  • NPI 1962992149
  NPD

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470873600000",
    "number": "1487910402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 5TH ST STE 211",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875055403",
            "telephone_number": "505-490-9049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 5TH ST STE 211",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875055403",
            "telephone_number": "505-490-9049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN NEW MEXICO NEUROPSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2016-08-11",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "505-490-9049",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "NM",
            "license": "1183",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "1183",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Clinical Neuropsychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.