Provider Demographics
NPI:1932731130
Name:ARCADIA NEUROPSYCHOLOGY, PLLC
Entity type:Organization
Organization Name:ARCADIA NEUROPSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KLINCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-216-1789
Mailing Address - Street 1:2929 N 44TH ST STE 330
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-7241
Mailing Address - Country:US
Mailing Address - Phone:480-216-1789
Mailing Address - Fax:
Practice Address - Street 1:2929 N 44TH ST STE 330
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-7241
Practice Address - Country:US
Practice Address - Phone:480-216-1789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty