Provider Demographics
NPI:1568262582
Name:A & N TELEPSYCH ASSESSMENT ASSOCIATES LLC
Entity type:Organization
Organization Name:A & N TELEPSYCH ASSESSMENT ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIKOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-352-9973
Mailing Address - Street 1:1354 E KINGSLEY ST STE E
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-7225
Mailing Address - Country:US
Mailing Address - Phone:417-441-7155
Mailing Address - Fax:
Practice Address - Street 1:1354 E KINGSLEY ST STE E
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-7225
Practice Address - Country:US
Practice Address - Phone:417-441-7155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty