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General NPI Number Information
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NPI Number | 1649412743
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Entity Type | Individual
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Provider Name | BRIAN PAUL KLINCK PSYD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2009
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 2999 N 44TH ST STE 415
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City | PHOENIX
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State | AZ
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Zip | 85018-7251
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Country | US
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Telephone | 602-675-0335
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Fax | 602-865-8089
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Provider Business Mailing Address
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Address Line | 2999 N 44TH ST STE 415
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City | PHOENIX
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State | AZ
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Zip | 85018-7251
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Country | US
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Telephone | 602-675-0335
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Fax | 602-865-8089
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PY1234
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4039
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 1897
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License Number State | SC
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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 | 4039
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY1234
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License Number State | NV
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Taxonomy #6
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1897
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License Number State | SC
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