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INSTITUTE FOR CLINICAL NEUROSCIENCES
NPI 1487192076
Clinical Neuropsychologist in Boulder, CO

Active since February 03, 2017
255 CANYON BLVD STE 300-F, BOULDER, CO 80302(972) 570-8200(972) 402-5621 Get Directions Write a Review

NPPES record last updated: January 2, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 2, 2019, Feb 6, 2017, Feb 3, 2017 (3 updates tracked since 2017).

About Institute For Clinical Neurosciences NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INSTITUTE FOR CLINICAL NEUROSCIENCES (NPI 1487192076) is a healthcare organization registered as a clinical neuropsychologist in Boulder, Colorado and active in the NPI registry since February 2017. The organization lists Bobby Lee Gant, President, as its authorized official.

NPPES Registry Identity

NPI1487192076
Entity TypeOrganization
Primary Taxonomy103G00000X
Legal Business NameICN PLLC
Location Address255 CANYON BLVD STE 300-FBoulder, CO 80302-4979
Mailing Address5455 Lee Hill DrBoulder, CO 80302-9305 · (720) 552-2995
Phone(972) 570-8200
Fax(972) 402-5621
Organization SubpartNo
Authorized OfficialBobby Lee GantPresident · (720) 552-2995
Enumeration DateFebruary 3, 2017
Last NPPES UpdateJanuary 2, 20193 updates tracked since enumeration
✔ NPI 1487192076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in CO · 2998
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
255 CANYON BLVD STE 300-F, Boulder, CO 80302
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Other Names 1

Doing Business AsInstitute For Clinical Neurosciences

Other Identifiers 1

Medicaid9000167953CO

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Icn PLLC's NPI number?

The NPI number for Icn PLLC is 1487192076. It was assigned to this organization in the NPPES registry on February 3, 2017. The provider is doing business as Institute For Clinical Neurosciences.

Where is Icn PLLC located?

Icn PLLC is located at 255 Canyon Blvd Ste 300-F, Boulder, CO 80302. The listed phone number is (972) 570-8200.

What is Icn PLLC's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

When was this NPI record last updated?

The NPPES record for Icn PLLC was last updated on January 2, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.