NPIMap

Organization Active NPI

Neurothryve

  • Clinical Psychologist
  • Vancouver, WA
National Provider Identifier
1851835920
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY60263831 Issued in WA
Legal business name
NEUROTHRYVE
Practice address
2621 NE 134TH St
Suite 340
Vancouver, WA 98686-3036
Phone
(360) 450-0140
Fax
(877) 343-0535
NPI assigned
Dec 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Authorized official

Name
Dr. Dani Nierenberg, PH.D., BCBNPI 1760604631
Title
Clinical Director
Phone
(360) 450-0150

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 PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY60263831 WA Primary

Addresses

Primary practice location

2621 NE 134TH St
Suite 340
Vancouver, WA 98686-3036

Mailing address

2621 NE 134TH St
Suite 340
Vancouver, WA 98686-3036
Phone (360) 450-0140

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1851835920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 NE 134TH ST",
            "address_2": "SUITE 340",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986863036",
            "telephone_number": "360-450-0140",
            "fax_number": "877-343-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 NE 134TH ST",
            "address_2": "SUITE 340",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986863036",
            "telephone_number": "360-450-0140",
            "fax_number": "877-343-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROTHRYVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-08",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "NIERENBERG",
        "authorized_official_first_name": "DANI",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "360-450-0150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., BCB"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60263831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.