DR. ROBERT CORY FANTO (NPI# 1912223454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912223454 |
| Entity Type | Individual |
| Full Name | DR. ROBERT CORY FANTO |
| Credential | PHD |
| Practice Address |
800 West Maple Street Medical Lake WA 99022-0800 |
| Mailing Address |
800 West Maple Street P O Box 800 Medical Lake WA 99022-0800 |
| Practice Telephone | 5095654000 |
| Practice Fax Number | 5055657015 |
| Mailing Telephone | 5095654000 |
| Mailing Fax Number | 5055657015 |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2010-04-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PY60127865 | WA | Behavioral Health & Social Service Providers |
| Street Address |
800 WEST MAPLE STREET |
| City | MEDICAL LAKE |
| State | WA |
| Zip Code | 99022-0800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437149440 | Imelda D. Goyanko-borrowmeo | Psychiatry & Neurology | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2005-10-21 |
| 1316299381 | Sabrina Arnott Keckalo | Physician Assistant | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2012-10-15 |
| 1184955874 | Sandra D Phillips | Dental Hygienist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2010-01-20 |
| 1508013764 | Nosrat Aflatooni | Physician Assistant | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2008-08-19 |
| 1275793671 | Miranda J Gordon | Occupational Therapist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2008-06-10 |
| 1043488570 | Michelle D Wellman | Occupational Therapy Assistant | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2008-02-19 |
| 1689749277 | Timothy J Pinnell | Occupational Therapy Assistant | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-11-21 |
| 1225107287 | Janice L Williams | Dental Hygienist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-11-06 |
| 1881763928 | Marcia L Ryan | Speech-Language Pathologist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-11-06 |
| 1679651970 | Eastern State Hospital Pharmacy | Psychiatric Hospital | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417462227 | Alicia Burton Dds Pllc | Clinic/Center | 47 E. Wa 902, Medical Lake, WA 99022 | 2017-12-04 |
| 1487100038 | Tammy Lee Adler | Pharmacist | 1010 W Fir St, Medical Lake, WA 99022 | 2016-09-01 |
| 1902281959 | Carmen Joy Berg | Pharmacist | 2320 South Salnave Road, Medical Lake, WA 99022 | 2015-07-20 |
| 1033546288 | Torrance Whitney Baldwin | Speech-Language Pathologist | 116 West 3rd St., Medical Lake, WA 99022 | 2013-10-02 |
| 1144572710 | Keri Lea Wissink | Speech-Language Pathologist | 116 West Thrird Street, Medical Lake, WA 99022 | 2012-10-08 |
| 1609153766 | Dutton Veterinary Medicine Pllc | Special Hospital | 212 East Lake Street, Medical Lake, WA 99022 | 2011-11-03 |
| 1881912962 | Susan L Vanwormer | Counselor | 108 N. Jefferson, Medical Lake, WA 99022 | 2010-05-13 |
| 1467774232 | Ryan K Love | Dentist | N 123 Brower Street, Medical Lake, WA 99022 | 2010-02-22 |
| 1023263464 | Emily S Mildes | Nurse Practitioner | 1451 W Maple, Medical Lake, WA 99022 | 2008-11-26 |
| 1619005014 | Maria Lydia Montenegro | General Practice | 2320 Salnave Rd, Lakeland Village, Medical Lake, WA 99022 | 2007-02-28 |
| Find all providers in zip 99022 | ||||
| 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 |
|---|---|---|---|---|
| 1821374430 | Jennifer Somerlott | Psychologist | 800 W Maple St, Medical Lake, WA 99022-5139 | 2011-10-26 |
| 1295905479 | Troy Lawn Bruner | Psychologist | 850 Maple Street, Medical Lake, WA 99022-0800 | 2008-03-04 |
| 1801964416 | Sonya Marie Wood | Psychologist | 850 W Maple St, Medical Lake, WA 99022-5139 | 2006-12-01 |
| 1649386509 | Nathan D Henry | Psychologist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2006-08-22 |
| 1023091329 | Darlene E. Walsh-martin | Psychologist | 850 Maple Street, Eastern State Hospital, Medical Lake, WA 99022-0800 | 2005-11-22 |
| 1538141148 | Trevor D Travers | Psychologist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2005-11-18 |
| 1619959194 | John J Williams | Psychologist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2005-11-18 |
| 1861474686 | Marsha H Blasingame | Psychologist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2005-11-17 |
| 1679555411 | W Timm Fredrickson | Psychologist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2005-11-17 |
| 1255313920 | Daniel J Lord-flynn | Psychologist | 800 West Maple Street, Medical Lake, WA 99022-0800 | 2005-11-17 |
| Find all providers in MEDICAL LAKE | ||||
| City | MEDICAL LAKE |
| Zip Code | 99022 |
Please comment or provide details below to improve the information on DR. ROBERT CORY FANTO.
| 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.