NPIMap

Organization Active NPI

Anxiety Disorders and Medical Psychology Treatment Center, P.C.

  • Clinical Psychologist
  • Flagstaff, AZ
National Provider Identifier
1518141985
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3538 Issued in AZ
Legal business name
ANXIETY DISORDERS AND MEDICAL PSYCHOLOGY TREATMENT CENTER, P.C.
Practice address
617 N Humphreys St
Suite 101
Flagstaff, AZ 86001-3063
Phone
(928) 779-3783
Fax
(928) 773-1150
NPI assigned
Dec 20, 2007
Last updated
Apr 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Authorized official

Name
Dr. Sumner Jay Sydeman, PH.D.NPI 1376755843
Title
Az Licensed Psychologist
Phone
(928) 779-3783

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3538 AZ Primary

Addresses

Primary practice location

617 N Humphreys St
Suite 101
Flagstaff, AZ 86001-3063

Mailing address

617 N Humphreys St
Suite 101
Flagstaff, AZ 86001-3063
Phone (928) 779-3783

National Provider Directory

National Provider Directory

Locations

617 N Humphreys St
Ste 101
Flagstaff, AZ 86001
Phone (928) 779-3783

450 Jordan Rd
Sedona, AZ 86336
Phone (928) 282-0221

Practitioners & affiliated clinicians

Practitioners 5

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": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1518141985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 N HUMPHREYS ST",
            "address_2": "SUITE 101",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013063",
            "telephone_number": "928-779-3783",
            "fax_number": "928-773-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 N HUMPHREYS ST",
            "address_2": "SUITE 101",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013063",
            "telephone_number": "928-779-3783",
            "fax_number": "928-773-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANXIETY DISORDERS AND MEDICAL PSYCHOLOGY TREATMENT CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "SYDEMAN",
        "authorized_official_first_name": "SUMNER",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "AZ LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "928-779-3783",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.