Provider Demographics
NPI:1861798068
Name:COMPREHENSIVE NEUROPSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:COMPREHENSIVE NEUROPSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:502-504-5231
Mailing Address - Street 1:815 JOHN HARPER RD UNIT 13
Mailing Address - Street 2:
Mailing Address - City:PIONEER VILLAGE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-7463
Mailing Address - Country:US
Mailing Address - Phone:502-504-5231
Mailing Address - Fax:502-504-5205
Practice Address - Street 1:815 JOHN HARPER RD UNIT 13
Practice Address - Street 2:
Practice Address - City:PIONEER VILLAGE
Practice Address - State:KY
Practice Address - Zip Code:40165
Practice Address - Country:US
Practice Address - Phone:502-504-5231
Practice Address - Fax:502-504-5205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1618103T00000X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P0022962OtherPASSPORT