Provider Demographics
NPI:1427308063
Name:FIELDS NEUROPSYCHOLOGY SERVICES, LLC
Entity type:Organization
Organization Name:FIELDS NEUROPSYCHOLOGY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:443-908-1692
Mailing Address - Street 1:17 WARREN RD
Mailing Address - Street 2:#3A
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5334
Mailing Address - Country:US
Mailing Address - Phone:443-908-1692
Mailing Address - Fax:
Practice Address - Street 1:17 WARREN RD
Practice Address - Street 2:#3A
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-5334
Practice Address - Country:US
Practice Address - Phone:443-908-1692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05106261QM0801X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health