NPIMap

Organization Active NPI

Black Mountain Neuropsychology, PLLC

  • Clinical Neuropsychologist
  • Scottsdale, AZ
National Provider Identifier
1548675077
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
BLACK MOUNTAIN NEUROPSYCHOLOGY, PLLC
Practice address
33755 N Scottsdale Rd
Suite J105
Scottsdale, AZ 85266-1567
Phone
(480) 575-5700
Fax
(866) 307-0007
NPI assigned
Jun 23, 2014
Last updated
Jun 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Authorized official

Name
Dr. Konstantinos D Thomopoulos, PSYDNPI 1801206115
Title
Member
Phone
(480) 575-5700

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 12

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X NU Primary
Psychologist 103T00000X NU
Addiction (Substance Use Disorder) Psychologist 103TA0400X NU
Adult Development & Aging Psychologist 103TA0700X NU
Cognitive & Behavioral Psychologist 103TB0200X NU
Clinical Psychologist 103TC0700X NU
Clinical Child & Adolescent Psychologist 103TC2200X NU
Family Psychologist 103TF0000X NU
Forensic Psychologist 103TF0200X NU
Group Psychotherapy Psychologist 103TP2701X NU
Rehabilitation Psychologist 103TR0400X NU
Health Psychologist 103TH0004X NU

Addresses

Primary practice location

33755 N Scottsdale Rd
Suite J105
Scottsdale, AZ 85266-1567

Mailing address

33755 N Scottsdale Rd
Suite J105
Scottsdale, AZ 85266-1567
Phone (480) 575-5700

National Provider Directory

National Provider Directory

Locations

33755 N Scottsdale Rd
Ste 105
Scottsdale, AZ 85266
Phone (480) 575-5700

Practitioners & affiliated clinicians

Practitioners 2

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": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403481600000",
    "number": "1548675077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33755 N SCOTTSDALE RD",
            "address_2": "SUITE J105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852661567",
            "telephone_number": "480-575-5700",
            "fax_number": "866-307-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33755 N SCOTTSDALE RD",
            "address_2": "SUITE J105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852661567",
            "telephone_number": "480-575-5700",
            "fax_number": "866-307-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK MOUNTAIN NEUROPSYCHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A",
        "authorized_official_last_name": "THOMOPOULOS",
        "authorized_official_first_name": "KONSTANTINOS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "480-575-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.