NPI Details
MODERN PSYCHOLOGIST NETWORK LLC is a psychologist in Temple, TX. The provider is 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. MODERN PSYCHOLOGIST NETWORK LLC NPI is 1437549755. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Advanced Life Innovations Pllc.
The provider's business location address is:
16 E AVENUE A STE 212
TEMPLE, TX
ZIP 76501
Phone: (305) 249-1694
Fax: (305) 647-6045
The provider's authorized official is Baron Crespo .
The authorized official title is Clinical & Forensic Psychologist and has the following contact phone number (305) 249-1694.
The enumeration date for this NPI number is 1/24/2015 and was last updated on 8/10/2018.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 103T00000X | Psychologist | | 37853 | TEXAS | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 381189501 | MEDICAID | TEXAS | |
| 2 | 631971 | OTHER | TEXAS | MEDICARE |
