Upa Pllc Ped Psychology in Jackson - Cognitive & Behavioral
Upa Pllc Ped Psychology - NPI 1467505222
Upa Pllc Ped Psychology is a Cognitive & Behavioral in Jackson, Mississippi. Upa Pllc Ped Psychology practices all healthcare services and medical treatments related to Cognitive & Behavioral. The NPI Number for Upa Pllc Ped Psychology is 1467505222. The last update date is 2020-08-22.
Upa Pllc Ped Psychology's current location address is 2500 N State St, Jackson, Mississippi. You can contact this provider via phone number 6019845274. The mailing address for Upa Pllc Ped Psychology is 2500 N State St, Jackson, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Upa Pllc Ped Psychology |
|---|---|
| Address | 2500 N State St, Jackson, Mississippi |
| Phone Number | 6019845274 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MANAGER |
|---|---|
| Authorized Official Name | Evans B Owen |
| Credentials | M.D. |
| Telephone Number | 6019845214 |
NPI Number Detail
| NPI Number | 1467505222 |
|---|---|
| Provider Enumeration Date | 2007-01-18 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 2500 N State St |
|---|---|
| City | Jackson |
| State | Mississippi (MS) |
| Post Code | 392164500 |
| Phone Number | 6019845274 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Cognitive & Behavioral |
|---|---|
| Taxonomy | 103Tb0200X |
|
Definition: A psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 9014561 | MS | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Upa Pllc Ped Psychology by the Centers for Medicare & Medicaid Services?
The Upa Pllc Ped Psychology has been issued the NPI (National Provider Identifier) 1467505222 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Upa Pllc Ped Psychology?
The Upa Pllc Ped Psychology is physically situated at 2500 N State St, in the city of Jackson, state of MS, with the postal code 392164500.
What is Upa Pllc Ped Psychology's specialized field of practice, and what is the corresponding taxonomy classification code?
The Upa Pllc Ped Psychology's area of specialization is Cognitive & Behavioral, and the corresponding taxonomy code that categorizes this field of practice is 103Tb0200X.
On what date was the 1467505222 assigned to Upa Pllc Ped Psychology?
The Upa Pllc Ped Psychology was issued its 1467505222 on 2007-01-18, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Upa Pllc Ped Psychology last refreshed?
The information related to the Upa Pllc Ped Psychology, including its address, specialty, and other relevant details, was last updated on 2020-08-22.