NPIMap

Organization Active NPI

Eating Disorder Recovery Services Professional Corporation

  • Clinical Psychologist
  • Reno, NV
National Provider Identifier
1629222013
Registry record updated Nov 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0360 Issued in NV
Legal business name
EATING DISORDER RECOVERY SERVICES PROFESSIONAL CORPORATION
Practice address
5365 Mae Anne Ave
Suite B-10
Reno, NV 89523-1840
Phone
(775) 287-2706
NPI assigned
Nov 11, 2008
Last updated
Nov 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2008

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

Authorized official

Name
Dr. Daniel Frederick Gunnarson, PH.D.NPI 1164581930
Title
President
Phone
(775) 287-2706

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY0360 NV Primary

Addresses

Primary practice location

5365 Mae Anne Ave
Suite B-10
Reno, NV 89523-1840

Mailing address

PO Box 2866
Reno, NV 89505-2866
Phone (775) 287-2706

National Provider Directory

National Provider Directory

Locations

5365 Mae Anne Ave
Ste B10
Reno, NV 89523
Phone (775) 746-6344

628 Lake St
Reno, NV 89501
Phone (702) 329-1717

Practitioners & affiliated clinicians

Practitioners 9

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": "1226361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1629222013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2866",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895052866",
            "telephone_number": "775-287-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5365 MAE ANNE AVE",
            "address_2": "SUITE B-10",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895231840",
            "telephone_number": "775-287-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EATING DISORDER RECOVERY SERVICES PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-11",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "GUNNARSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "775-287-2706",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PY0360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

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