Organization Active NPI

Neurobehavioral Associates LTD

  • Psychologist
  • Mansfield, OH
National Provider Identifier
1871570390
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
NEUROBEHAVIORAL ASSOCIATES LTD
Practice address
462 Park Ave West
Mansfield, OH 44906
Phone
(419) 529-9944
Fax
(419) 529-9989
NPI assigned
Dec 27, 2005
Last updated
Jan 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Authorized official

Name
Diana Sue Wilkerson, PHD
Title
President
Phone
(419) 529-9944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

462 Park Ave West
Mansfield, OH 44906

Mailing address

462 Park Ave West
Mansfield, OH 44906
Phone (419) 529-9944

Other identifiers 1

IdentifierTypeStateIssuer
2294360MedicaidOH

National Provider Directory

National Provider Directory

Locations

1230 Lexington Ave
Ste 202
Mansfield, OH 44907
Phone (419) 709-4752

Practitioners & affiliated clinicians

Practitioners 3

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": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1871570390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 PARK AVE WEST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "44906",
            "telephone_number": "419-529-9944",
            "fax_number": "419-529-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 PARK AVE WEST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "44906",
            "telephone_number": "419-529-9944",
            "fax_number": "419-529-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROBEHAVIORAL ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-27",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-529-9944",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2294360",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

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