NPIMap

Organization Active NPI

Abintra Psychological Associates, LLC

  • Clinical Psychologist
  • Buffalo, WY
National Provider Identifier
1710122908
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
#268 Issued in WY
Legal business name
ABINTRA PSYCHOLOGICAL ASSOCIATES, LLC
Practice address
135 Pine St Ste B
Buffalo, WY 82834-2332
Phone
(307) 684-5828
Fax
(307) 684-5803
NPI assigned
Dec 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Authorized official

Name
Dr. Theresa A Faulkner, PH.D.
Title
Owner
Phone
(307) 684-5828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X #268 WY Primary

Addresses

Primary practice location

135 Pine St Ste B
Buffalo, WY 82834-2332

Mailing address

135 Pine St Ste B
PO Box 1222
Buffalo, WY 82834-2332
Phone (307) 684-5828

National Provider Directory

National Provider Directory

Locations

175 Pine St
Buffalo, WY 82834
Phone (307) 684-5828

135 Pine St
Ste B
Buffalo, WY 82834
Phone (307) 684-5828

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228176000000",
    "number": "1710122908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 PINE ST STE B",
            "address_2": "PO BOX 1222",
            "city": "BUFFALO",
            "state": "WY",
            "postal_code": "828342332",
            "telephone_number": "307-684-5828",
            "fax_number": "307-684-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PINE ST STE B",
            "city": "BUFFALO",
            "state": "WY",
            "postal_code": "828342332",
            "telephone_number": "307-684-5828",
            "fax_number": "307-684-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABINTRA PSYCHOLOGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-02",
        "last_updated": "2008-12-02",
        "status": "A",
        "authorized_official_last_name": "FAULKNER",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-684-5828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WY",
            "license": "#268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.