NPI 1851054266 · live from the CMS NPI Registry
Behavioral Neuropsychology LLC
Psychologist, Clinical Child & Adolescent in Portland, OR. National Provider Identifier 1851054266, active.
NPI record
| NPI | 1851054266 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical Child & Adolescent 103TC2200X |
| Practice location | 2130 Sw Jefferson St Ste 300, Portland, OR 97201 |
| Practice phone | 503-539-4932 |
| Enumerated | October 21, 2021 |
| Last updated | December 7, 2022 |
| Authorized official | Michael Fulop, Owner |
| Other names | Bdtxpdx |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Health | 103TH0004X | — |
| Clinic/Center, Adolescent and Children Mental Health | 261QM0855X | — |
| Psychologist, Clinical Child & Adolescent primary | 103TC2200X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.