Carolina Neuropsychological Service, Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0111 Issued in NC

Legal business name

CAROLINA NEUROPSYCHOLOGICAL SERVICE, INC

Practice address

1540 Sunday Dr
Suite 200
Raleigh, NC 27607-6000

Phone

(919) 859-9040

Fax

(919) 859-9030

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Robert Lake Conder Jr., PSY.D.

Title

President

Phone

(919) 859-9040

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Bartholomew Dominick Brigidi Jr., PHD

  • Psychologist
  • Durham, NC
  • NPI 1801997432
  NPD (past)
• William Thomas Bundick Jr., PH.D.

  • Clinical Psychologist
  • Raleigh, NC
  • NPI 1396838058
  NPD (past)
• Cheryl Corcoran Citron, PH.D.

  • Psychologist
  • Raleigh, NC
  • NPI 1205932563
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972609204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 SUNDAY DR",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076000",
            "telephone_number": "919-859-9040",
            "fax_number": "919-859-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 SUNDAY DR",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076000",
            "telephone_number": "919-859-9040",
            "fax_number": "919-859-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA NEUROPSYCHOLOGICAL SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONDER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LAKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-859-9040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NC",
            "license": "0111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Immediate Care , P.a.
• Carolina Kids Pediatric Associates
• Carolina Kids Therapy
• Carolina Neighbors Home Care, LLC
• Carolina Neurology Consultants
• Carolina Neuroscience Institute, PC
• Carolina North Transportation
• Carolina Nutrition Specialists
• Carolina Optometry Associates, P.a.
• Carolina Outpatient Detox, LLC

• Psychologist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.