NPIMap

Organization Active NPI

Carolina Neuropsychological Service, Inc

  • Psychologist
  • Raleigh, NC
National Provider Identifier
1972609204
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
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
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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.NPI 1891892337
Title
President
Phone
(919) 859-9040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 0111 NC Primary

Addresses

Primary practice location

1540 Sunday Dr
Suite 200
Raleigh, NC 27607-6000

Mailing address

1540 Sunday Dr
Suite 200
Raleigh, NC 27607-6000
Phone (919) 859-9040

National Provider Directory

National Provider Directory

Locations

3900 Barrett Dr
Ste 102
Raleigh, NC 27609
Phone (919) 859-9040

Practitioners & affiliated clinicians

Practitioners 4

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": "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": []
}

Other providers in Raleigh, NC

Sources for this page

  • 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.