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General NPI Number Information
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NPI Number | 1619042181
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Entity Type | Organization
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Legal Business Name | ASSOCIATED NEURO & PSYCHOLOGICAL SPECIALTIES
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1701 N GREEN VALLEY PKWY SUITE 2-A
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City | HENDERSON
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State | NV
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Zip | 89074-5885
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Country | US
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Telephone | 702-650-0590
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Fax | 702-650-0591
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Provider Business Mailing Address
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Address Line | 1701 N GREEN VALLEY PKWY SUITE 2-A
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City | HENDERSON
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State | NV
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Zip | 89074-5885
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Country | US
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Telephone | 702-650-0590
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Fax | 702-650-0591
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Authorized Official
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Title or Position | CEO
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Name | DR. LYNN SHERIDAN PORTER
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Credential | PHD LCSW
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Telephone | 702-650-0590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 307C
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 307C
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 307C
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License Number State | NV
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