THE NORDAL CLINIC, PA (NPI# 1558483743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558483743 |
| Entity Type | Organization |
| Organization Name | THE NORDAL CLINIC, PA |
| Practice Address |
1121 Grove St Vicksburg MS 39183-2913 |
| Practice Telephone | 6016340118 |
| Practice Fax Number | 6016300302 |
| Mailing Telephone | 6016340118 |
| Mailing Fax Number | 6016300302 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KATHERINE C NORDAL (PRESIDENT) |
| Authorized Official Telephone | 6016340118 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TH0100X |
Psychologist Specialization: Health Service |
MS | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09011887 | 05 |
| Street Address |
1121 GROVE ST |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39183-2913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790886653 | Katherine C. Nordal | Psychologist | 1121 Grove St, Vicksburg, MS 39183-2913 | 2006-09-25 |
| 1407001100 | Barbara Warner Martin | Psychologist | 1121 Grove St, Vicksburg, MS 39183-2913 | 2008-11-21 |
| 1942391180 | Angela J. Koestler | Psychologist | 1121 Grove St, Vicksburg, MS 39183-2913 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306217823 | Tracy Curtis | Speech-Language Pathologist | 2100 Us 61, Vicksburg, MS 39183 | 2015-10-09 |
| 1649566894 | The Life Balance Clinic, Behavioral Health Service | Social Worker | 1107 B Openwood St., Vicksburg, MS 39183 | 2011-06-27 |
| 1245428788 | Melanie Joan Waldrop | Nurse Anesthetist, Certified Registered | 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183 | 2007-10-10 |
| 1871714477 | Robert Michael Coleman | Dentist | 2356 Grove Street, Vicksburg, MS 39183 | 2007-05-01 |
| 1942363502 | Visions Physical Therapy | Physical Therapist | 110 Holt Collier Dr, Vicksburg, MS 39183 | 2006-12-18 |
| 1023117991 | Janet S Fisher Dmd Pa | Dentist | 1212 Mission 66, Vicksburg, MS 39183 | 2006-09-21 |
| 1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
| 1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
| 1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
| 1255777025 | Joyce Wanjugu Muruthi | Obstetrics & Gynecology | 2100 Highway 61 N, Vicksburg, MS 39183 | 2013-05-20 |
| Find all providers in zip 39183 | ||||
| Taxonomy Code | 103TH0100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health Service |
| A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |
| Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942391180 | Angela J. Koestler | Psychologist | 1121 Grove St, Vicksburg, MS 39183-2913 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033203468 | Ronald Wayne Alexander Jr. | Psychologist | 301 Fisher Street, Ste 107, 81 Mdos/sgoh, Keesler Afb, MS 39534 | 2006-10-02 |
| 1568093912 | Irby Psychological Services, LLC | Psychologist | 7075 Golden Oaks Loop W, Southaven, MS 38671-9010 | 2020-02-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.