PHILIP E SUNDSTROM (NPI# 1750594115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750594115 |
| Entity Type | Individual |
| Full Name | PHILIP E SUNDSTROM |
| Credential | M.A.,LIC PSYCHOLOGIS |
| Practice Address |
209 W Maple Ave Fayetteville WV 25840-1413 |
| Practice Telephone | 3045742100 |
| Practice Fax Number | 3045742151 |
| Mailing Telephone | 3045742100 |
| Mailing Fax Number | 3045742151 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 257 | WV | Behavioral Health & Social Service Providers |
| Street Address |
209 W MAPLE AVE |
| City | FAYETTEVILLE |
| State | WV |
| Zip Code | 25840-1413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134279581 | Stephanie Jill Daniel | Psychologist | 209 W Maple Ave, Fayetteville, WV 25840-1413 | 2007-01-10 |
| 1023617081 | Cynthia Ann Bail | Case Manager/Care Coordinator | 209 W Maple Ave, Fayetteville, WV 25840-1413 | 2020-10-21 |
| 1518581404 | Heather Renee Collins | Social Worker | 209 W Maple Ave, Fayetteville, WV 25840-1413 | 2020-06-05 |
| 1962912410 | Wendy Pruett Young | Counselor | 209 W Maple Ave, Fayetteville, WV 25840-1413 | 2017-10-10 |
| 1134552888 | Rebecca Rae Stone | Psychologist | 209 W Maple Ave, Fayetteville, WV 25840-1413 | 2013-08-16 |
| 1548473903 | Mark Vincent Sundstrom | Social Worker | 209 W Maple Ave, Fayetteville, WV 25840-1413 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447766639 | Nancy Carol Myles | Technician | 171 Wood Rd, Fayetteville, WV 25840 | 2017-12-26 |
| 1598933954 | Kembra Anne Crist | Registered Nurse | 111 Fayette Avenue, Fayette County Boe, Fayetteville, WV 25840 | 2008-02-19 |
| 1003004854 | Edward Lee Winter | Psychologist | 111 Fayette Ave., Fayette County Schools, Fayetteville, WV 25840 | 2007-10-05 |
| 1811109432 | Anita Louise Swanson | Physical Therapist | 111 Fayette Ave, Fayetteville, WV 25840 | 2007-05-04 |
| 1003964008 | Krista L Copenhaver-mackowiak | Nurse Anesthetist, Certified Registered | 613 Crooked Run Rd, Fayetteville, WV 25840 | 2007-01-08 |
| 1922171024 | Carl Arthur Hansen | Dentist | 215 North Court St, Fayetteville, WV 25840 | 2006-11-16 |
| 1932202447 | Appalachian Regional Healthcare | Clinic/Center | 436 Elizabeth Way, Fayetteville, WV 25840 | 2006-09-07 |
| 1154424810 | West Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 72 Whitewater Ave, Fayetteville, WV 25840 | 2006-09-07 |
| 1447241310 | Karen L. Pettry-hultman | Family Medicine | Rr 3 Box 9, Fayetteville, WV 25840 | 2005-10-31 |
| 1598125577 | Jeanne Black | Registered Nurse | 111 Fayette Avenue, Fayette County Schools, Fayetteville, WV 25840 | 2016-03-03 |
| Find all providers in zip 25840 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952939811 | A4psychology, Pllc | Psychologist | 596 Executive Pl Ste 201, Fayetteville, NC 28305-5189 | 2020-03-27 |
| 1639725161 | Lauren Rosso | Psychologist | 19 E Mountain St Ste 5, Fayetteville, AR 72701-6067 | 2019-08-12 |
| 1457819963 | Word Wellness Center, LLC | Psychologist | 6836 E Genesee Street, Suite A, Fayetteville, NY 13066 | 2019-03-05 |
| 1912483348 | Young Psychological Services, Pllc | Psychologist | 3800 Sunchase Dr, Fayetteville, NC 28306-8099 | 2018-07-18 |
| 1265951784 | Robert D Felner | Psychologist | 1255 N Montview Dr, Fayetteville, AR 72701-2892 | 2017-09-15 |
| 1851814230 | Blakely Low | Psychologist | 1229 Meadow Street Suite #221, Jones Family Center for Student-athlete Success, Fayetteville, AR 72701 | 2017-07-18 |
| 1528479169 | Rebecca Crain | Psychologist | 2504 Raeford Rd Ste 102, Fayetteville, NC 28305-5135 | 2014-05-16 |
| 1114344330 | Lesley Teitelbaum | Psychologist | 5080 Bridle Path Rd, Fayetteville, NY 13066-9734 | 2014-03-26 |
| 1740605062 | Kimberlee Alane Cooper | Psychologist | 1200 Fairmont Ct, Fayetteville, NC 28304-4403 | 2014-02-24 |
| 1497176093 | Cheryl Funsch Smith | Psychologist | 2031 N Green Acres Rd Ste A, Fayetteville, AR 72703-2619 | 2013-12-27 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 25840 |
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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.