Provider Demographics
NPI:1003240235
Name:MACY PSYCHOLOGY, INC
Entity Type:Organization
Organization Name:MACY PSYCHOLOGY, INC
Other - Org Name:THE CENTER FOR BEHAVIOR CHANGE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:MACY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:619-876-8261
Mailing Address - Street 1:7676 HAZARD CENTER DR STE 500
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4508
Mailing Address - Country:US
Mailing Address - Phone:619-876-8261
Mailing Address - Fax:
Practice Address - Street 1:7676 HAZARD CENTER DR STE 500
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4508
Practice Address - Country:US
Practice Address - Phone:619-876-8261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 20536251S00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency