The Clinebell Institute

Primary specialty

PsychologistTaxonomy code 103T00000X

License

22920 Issued in CA

Legal business name

THE CLINEBELL INSTITUTE

Practice address

1325 North College Avenue
3Rd Floor Butler Building
Claremont, CA 91711-3154

Phone

(909) 451-3690

Fax

(909) 447-6351

NPI assigned

Dec 30, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kyungsig Samuel Lee, PH.D.NPI 1447845045

Title

Executive Director of the Clinebell

Phone

(626) 616-2478

Specialties & licenses 2

Addresses

Tax ID family

The Clinebell Institute2 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.

• The Clinebell Institute

  • Community/Behavioral Health Agency
  • Claremont, CA
  • NPI 1326258609
  NPD tax ID

Locations

Practitioners 1

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

• Kyungsig Samuel Lee, PHD

  • Cognitive & Behavioral Psychologist
  • Claremont, CA
  • NPI 1447845045
  NPD Authorized official

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

{
    "created_epoch": "1262131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262131200000",
    "number": "1922338722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 NORTH COLLEGE AVENUE",
            "address_2": "3RD FLOOR BUTLER BUILDING",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113154",
            "telephone_number": "909-451-3690",
            "fax_number": "909-447-6351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 NORTH COLLEGE AVENUE",
            "address_2": "3RD FLOOR BUTLER BUILDING",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113154",
            "telephone_number": "909-451-3690",
            "fax_number": "909-447-6351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CLINEBELL INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-30",
        "last_updated": "2009-12-30",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KYUNGSIG",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF THE CLINEBELL",
        "authorized_official_telephone_number": "626-616-2478",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "22920",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "16926",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Claremont, CA
• Providers in Claremont, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.