Provider Demographics
NPI:1871355271
Name:ELEMENT CENTER FOR NEURODEVELOPMENT
Entity type:Organization
Organization Name:ELEMENT CENTER FOR NEURODEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNKIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:406-200-9079
Mailing Address - Street 1:3972 US HIGHWAY 93 N STE G
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-6469
Mailing Address - Country:US
Mailing Address - Phone:406-200-9079
Mailing Address - Fax:406-641-3530
Practice Address - Street 1:3972 US HIGHWAY 93 N STE G
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-6469
Practice Address - Country:US
Practice Address - Phone:406-200-9079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty