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General NPI Number Information
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NPI Number | 1407167059
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Entity Type | Organization
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Legal Business Name | PERSONNEL ASSESSMENTS INC.
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Dates
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Enumeration Date | 06/29/2010
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 201 E ARMY TRAIL RD SUITE 306
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2150
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Country | US
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Telephone | 630-539-2620
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Fax | 847-466-7510
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Provider Business Mailing Address
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Address Line | 201 E ARMY TRAIL RD SUITE 306
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2150
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Country | US
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Telephone | 630-539-2620
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Fax | 847-466-7510
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Authorized Official
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Title or Position | LICENSED CLINNCAL PSYCHOLOGIST
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Name | DR. KELLINE EVANS MATHEWS
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Credential | PSY.D.
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Telephone | 630-539-2620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 071005973
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 071005973
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071005973
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 071005973
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License Number State | IL
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