Provider Demographics
NPI:1609756972
Name:BRAIN CENTRIC NEUROPSYCHOLOGY
Entity type:Organization
Organization Name:BRAIN CENTRIC NEUROPSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNEL
Authorized Official - Middle Name:HK
Authorized Official - Last Name:ELHELOU
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:818-800-0514
Mailing Address - Street 1:4607 LAKEVIEW CANYON RD STE 138
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4028
Mailing Address - Country:US
Mailing Address - Phone:818-800-0514
Mailing Address - Fax:
Practice Address - Street 1:12791 LONE TRAIL CT
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-1168
Practice Address - Country:US
Practice Address - Phone:818-800-0514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty