Provider Demographics
NPI:1861288151
Name:PSYCHOLOGICAL TESTING CENTER
Entity type:Organization
Organization Name:PSYCHOLOGICAL TESTING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:FUNK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:770-568-3896
Mailing Address - Street 1:1084 N POINTE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-9751
Mailing Address - Country:US
Mailing Address - Phone:770-568-3896
Mailing Address - Fax:770-568-3896
Practice Address - Street 1:200 W MONROE ST STE 307
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-3997
Practice Address - Country:US
Practice Address - Phone:309-909-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty