CAPITAL CITY NEUROPSYCHOLOGY, LLC (NPI# 1801352695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801352695 |
| Entity Type | Organization |
| Organization Name | CAPITAL CITY NEUROPSYCHOLOGY, LLC |
| Practice Address |
6000 Garners Ferry Rd Ste 12 Columbia SC 29209-1303 |
| Practice Telephone | 8037907095 |
| Mailing Telephone | 8037907095 |
| Enumeration Date | 2019-02-16 |
| Last Update Date | 2019-02-16 |
| Authorized Official Name | DR. BRANDON LARS ROBERG (CLINICAL NEUROPSYCHOLOGIST) |
| Authorized Official Telephone | 8037087095 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| Street Address |
6000 GARNERS FERRY RD STE 12 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29209-1303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992293013 | Pertile Group LLC | Family Medicine | 26 Foot Point Rd, Columbia, SC 29209 | 2018-04-24 |
| 1083156061 | Derek Clark | Physical Therapist | 6349 Garners Ferry Rd, Columbia, SC 29209 | 2016-11-08 |
| 1922450345 | Heather Alexander | Social Worker | 6439 Garners-ferry Road, Suite 122, Wjb Dorn Va, Columbia, SC 29209 | 2016-07-09 |
| 1265888325 | Daphne Elaine Allen | Counselor | 1850 Pinview Dr, Columbia, SC 29209 | 2016-05-09 |
| 1659757649 | Marc Edmundson | Pharmacist | 500 Gills Creek Pkwy #810, Columbia, SC 29209 | 2015-08-03 |
| 1477949113 | Winter Years Home Health Care Agency, LLC | Home Health | 1101 1st Street, P, Columbia, SC 29209 | 2015-04-09 |
| 1285045773 | Alireza Adhami | Pharmacist | 7235 Garners Ferry Rd, Columbia, SC 29209 | 2014-05-19 |
| 1790039212 | Immediate Dental Group Columbia | Dentist | 1118 Greenlawn Drive, Columbia, SC 29209 | 2012-11-06 |
| 1275896284 | Tariq Horani | Internal Medicine | 6349 Garners Ferry Road, Int Med -, Columbia, SC 29209 | 2012-06-25 |
| 1902165467 | Medcare Urgent Care Center Garners Ferry, LLC | Clinic/Center | 7418 Garners Ferry Road, Columbia, SC 29209 | 2012-05-03 |
| Find all providers in zip 29209 | ||||
| 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 |
|---|---|---|---|---|
| 1760004832 | Kehinde Bolajoko Abioye | Clinical Neuropsychologist | 10420 Little Patuxent Pkwy Ste 250, Columbia, MD 21044-3638 | 2020-05-12 |
| 1578909925 | Sharon Brooks | Clinical Neuropsychologist | 2209 Potomac Dr, Columbia, MO 65203-5886 | 2013-05-13 |
| 1144411513 | Maureen O'kane Grissom | Clinical Neuropsychologist | Thompson Center, 300 Portland St., Suite, 110, Columbia, MO 65211-0001 | 2007-08-09 |
| 1174686356 | Shawna Blake Kirby | Clinical Neuropsychologist | 1705 Richland St, Columbia, SC 29201-2635 | 2006-12-18 |
| 1104434190 | Andrew Mark Kiselica | Clinical Neuropsychologist | 115 W Business Loop 70, Columbia, MO 65203-3244 | 2020-07-16 |
| 1750902581 | Yesenia Serrano | Clinical Neuropsychologist | 6439 Garners Ferry Rd, Columbia, SC 29209-1638 | 2020-05-04 |
| 1598137127 | Melissa Blackwell | Clinical Neuropsychologist | 5565 Sterrett Pl, Ste 320, Columbia, MD 21044-2665 | 2015-10-22 |
| 1255762399 | American Psychiatric Group Pa | Clinical Neuropsychologist | 8640 Guilford Rd, Suite 251, Columbia, MD 21046-2655 | 2013-11-27 |
| 1497035612 | Myriam J Sollman | Clinical Neuropsychologist | 3 Richland Medical Park Dr Ste 310, Columbia, SC 29203-6862 | 2011-08-18 |
| 1538490834 | Elena Theressa Harlan Drewel | Clinical Neuropsychologist | 300 Portland St, Suite 110, Columbia, MO 65201-6569 | 2010-01-26 |
| Find all providers in COLUMBIA | ||||
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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.