Healthcare Provider Details

I. General information

NPI: 1942804190
Provider Name (Legal Business Name): SAPIENCE PSYCHOLOGY AND PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2020
Last Update Date: 02/09/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 WILLOW ST
RENO NV
89502-1304
US

IV. Provider business mailing address

834 WILLOW ST
RENO NV
89502-1304
US

V. Phone/Fax

Practice location:
  • Phone: 321-961-5989
  • Fax: 775-409-4779
Mailing address:
  • Phone: 775-800-6030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HERBERT FLETCHER COARD III
Title or Position: MANAGING PARTNER
Credential: ED.D.
Phone: 321-961-5989