=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942208814
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEUROPSYCHOLOGY CONSULTANTS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2005
-----------------------------------------------------
Last Update Date | 04/03/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 195 DANBURY RD STE 230
-----------------------------------------------------
City | WILTON
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06897-4075
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-855-9691
-----------------------------------------------------
Fax | 203-855-7743
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 195 DANBURY RD STE 230
-----------------------------------------------------
City | WILTON
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06897-4075
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-855-9691
-----------------------------------------------------
Fax | 203-855-7743
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER/OWNER
-----------------------------------------------------
Name | DR. ROBERT PHILLIP TEPLEY
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 203-855-9691
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 001410
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103G00000X
-----------------------------------------------------
Taxonomy Name | Clinical Neuropsychologist
-----------------------------------------------------
License Number | 002279
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------