Senior Psychology LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00001983 Issued in WA

Legal business name

SENIOR PSYCHOLOGY LLC

Practice address

9340 NE 76TH St
Vancouver, WA 98662-3721

Phone

(360) 253-4912

Fax

(360) 253-5170

NPI assigned

Jun 17, 2009

Organization subpart

No

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

Authorized official

Name

Dr. David W Agnor, PHDNPI 1114971462

Title

Executive Director

Phone

(360) 253-4912

Specialties & licenses 1

Addresses

Tax ID family

Senior Connections2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Senior Psychology LLC

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1972730042
  NPD tax ID

Practitioners 1

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

• David W Agnor, PHD

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1114971462
  NPD (past) Authorized official

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1649407644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9340 NE 76TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986623721",
            "telephone_number": "360-253-4912",
            "fax_number": "360-253-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9340 NE 76TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986623721",
            "telephone_number": "360-253-4912",
            "fax_number": "360-253-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-17",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "AGNOR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-253-4912",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00001983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charul Sen, M.D
• Priya Sen
• Melissa Xaviera Sencion
• Gladwyn Senibalo
• Senior Connections Psychiatry PLLC.
• Senior Psychology LLC
• Janet K Senning, R.PH.
• Robert C Senning, PA
• Sentience Psychotherapy LLC
• Jongwon Seo

• Clinical Psychologist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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.