Provider Demographics
NPI:1285072371
Name:NEUROPSYCHOLOGY ASSOCIATES, PLLC
Entity type:Organization
Organization Name:NEUROPSYCHOLOGY ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERENGUER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:615-784-8142
Mailing Address - Street 1:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38088-0847
Mailing Address - Country:US
Mailing Address - Phone:615-784-8142
Mailing Address - Fax:615-691-7140
Practice Address - Street 1:1000 PHYSICIANS WAY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-1471
Practice Address - Country:US
Practice Address - Phone:615-784-8142
Practice Address - Fax:615-691-7140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-11
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3148103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103G701223OtherMEDICARE ORGANIZATION PTAN
TNQ002226Medicaid