Provider Demographics
NPI:1306546460
Name:GENERATIONS NEUROPSYCHOLOGY, LLC
Entity type:Organization
Organization Name:GENERATIONS NEUROPSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNELIZABETH
Authorized Official - Middle Name:ROBINSON
Authorized Official - Last Name:CARLEW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:601-202-2472
Mailing Address - Street 1:109 ELIZABETH AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-8329
Mailing Address - Country:US
Mailing Address - Phone:601-826-7841
Mailing Address - Fax:769-333-9172
Practice Address - Street 1:4500 I 55 N STE 234
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-5932
Practice Address - Country:US
Practice Address - Phone:601-202-2472
Practice Address - Fax:769-333-9172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty