DR. EMMA LEE PEDEN (NPI# 1669896809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1669896809 |
Entity Type | Individual |
Full Name | DR. EMMA LEE PEDEN |
Credential | PSY.D. |
Practice Address |
702 Carr Cir Headland AL 36345-1916 |
Mailing Address |
Po Box 524 Headland AL 36345-0524 |
Practice Telephone | 3347187332 |
Mailing Telephone | 3347187332 |
Enumeration Date | 2014-02-07 |
Last Update Date | 2014-02-07 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | 1856 | AL | Behavioral Health & Social Service Providers |
N | 103T00000X | Psychologist | 1856 | AL | Behavioral Health & Social Service Providers |
N | 103TC0700X |
Psychologist Specialization: Clinical |
1856 | AL | Behavioral Health & Social Service Providers |
Street Address |
702 CARR CIR |
City | HEADLAND |
State | AL |
Zip Code | 36345-1916 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922556877 | Christoline Nichole Daniels | Specialist/Technologist | 100 Benjamin Way, Headland, AL 36345 | 2016-09-20 |
1174939326 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 14331 County Rd 99, Headland, AL 36345 | 2014-07-09 |
1366551301 | Jimmy Hinson King | Dentist | 123 Holman Drive, Headland, AL 36345 | 2006-08-30 |
1104858042 | Brent Thomas Tucker | Psychologist | 525.5 Church St, Headland, AL 36345 | 2006-07-07 |
1265450282 | Massvax Travel Clinic L.L.C. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 113 Parkside Dr, Headland, AL 36345-1520 | 2006-07-17 |
1407291099 | Matthew J Welch | Student in an Organized Health Care Education/Training Program | 307 Knowles Rd, Headland, AL 36345-1541 | 2013-05-08 |
1437221041 | City of Headland | Ambulance | 456 E Main St, Headland, AL 36345-1850 | 2006-11-15 |
1508892928 | Stanley Ray Mccardle | Dentist | 812 Mitchell St, Headland, AL 36345-2100 | 2006-06-25 |
1104969880 | Henry County Health Dept-headland Adult Immun | Public Health or Welfare | 2 Cable St, Headland, AL 36345-2136 | 2007-02-14 |
1932620168 | Henry County Health Dept (headland) Std | Public Health or Welfare | 2 Cable St, Headland, AL 36345-2136 | 2017-06-28 |
Find all providers in zip 36345 |
Taxonomy Code | 103G00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Clinical Neuropsychologist |
An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205457504 | Elaine Joy Mahoney | Clinical Neuropsychologist | 1717 6th Ave S # Src190, Birmingham, AL 35233-1801 | 2020-04-28 |
1083958813 | William Jeffrey Bryson | Clinical Neuropsychologist | 250 Chateau Dr Sw Ste 145, Huntsville, AL 35801-6437 | 2012-11-16 |
1376893032 | Thomas Joseph Conboy | Clinical Neuropsychologist | 1200 14th St, Suite A, Phenix City, AL 36867-4907 | 2012-09-10 |
1295025997 | Sharon D Waltz | Clinical Neuropsychologist | 1365 Caliston Way, Pelham, AL 35124 | 2011-04-14 |
1356671408 | Kimberly Jones Rogers | Clinical Neuropsychologist | 200 Grove Park Ln Ste 212, Dothan, AL 36305 | 2010-01-12 |
1548493000 | Henry R. Griffith, Ph.d. | Clinical Neuropsychologist | 1025 23rd St S, Suite 100, Magnolia Financial Building, Birmingham, AL 35205-2499 | 2009-09-01 |
1497989370 | Gove Hill Memorial Hospital, Inc | Clinical Neuropsychologist | 295 South Jackson Street, Grove Hill, AL 36451-0935 | 2009-05-07 |
1013193010 | Joanna T Koulianos | Clinical Neuropsychologist | 22 N Florida St, Mobile, AL 36607-3108 | 2008-01-21 |
1093996985 | Neuropsychology Clinic | Clinical Neuropsychologist | 2804 20th Ave, Northport, AL 35476-3835 | 2007-11-19 |
1912108838 | Neurolife, LLC | Clinical Neuropsychologist | 7501 Memorial Pkwy Sw, Suite 101, Huntsville, AL 35802-2204 | 2007-05-29 |
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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.