=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922291525
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PSYCHOLOGY & COUNSELING CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2007
-----------------------------------------------------
Last Update Date | 10/05/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 511 N MUR LEN RD STE A
-----------------------------------------------------
City | OLATHE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66062-1208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-764-1194
-----------------------------------------------------
Fax | 913-764-1195
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 511 N MURLEN RD STE A
-----------------------------------------------------
City | OLATHE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66062-1208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-764-1194
-----------------------------------------------------
Fax | 913-764-1195
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. EDWARD P NEUFELD
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 913-764-1194
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | LP0341
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------