Branson Psychological & Diagnostic Services PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PYO1867 Issued in MO

Legal business name

BRANSON PSYCHOLOGICAL & DIAGNOSTIC SERVICES PC

Practice address

574 State Highway 248
Suite 3
Branson, MO 65616-7740

Phone

(417) 335-8466

Fax

(417) 335-8566

NPI assigned

Jan 4, 2007

Last updated

Mar 25, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marci Michelle Manna, PSY.D.

Title

Clinical Psychologist

Phone

(417) 335-8466

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301011200000",
    "number": "1689721698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "574 STATE HIGHWAY 248",
            "address_2": "SUITE 3",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167740",
            "telephone_number": "417-335-8466",
            "fax_number": "417-335-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "574 STATE HIGHWAY 248",
            "address_2": "SUITE 3",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167740",
            "telephone_number": "417-335-8466",
            "fax_number": "417-335-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANSON PSYCHOLOGICAL & DIAGNOSTIC SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2011-03-25",
        "status": "A",
        "authorized_official_last_name": "MANNA",
        "authorized_official_first_name": "MARCI",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "417-335-8466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "PYO1867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "499660603",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• James T Brawner, M.D.

• Clinical Psychologist in Branson, MO
• Providers in Branson, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; 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.