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General NPI Number Information
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NPI Number | 1740066141
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Entity Type | Organization
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Legal Business Name | PERSON CENTERED NEUROPSYCHOLOGY, LLC
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Dates
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Enumeration Date | 09/01/2023
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Last Update Date | 10/21/2023
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Provider Practice Location Address
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Address Line | 15 MEADOW ST UNIT 1
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City | LITCHFIELD
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State | CT
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Zip | 06759-3504
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Country | US
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Telephone | 203-513-3190
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Fax |
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Provider Business Mailing Address
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Address Line | 980 NORTHFIELD RD
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City | WATERTOWN
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State | CT
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Zip | 06795-1421
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Country | US
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Telephone | 203-209-8861
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Fax |
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Authorized Official
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Title or Position | MANAGER/NEUROPSYCHOLOGIST
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Name | DR. LASHA CORBETT
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Credential | PSY.D.
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Telephone | 203-209-8861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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