Provider Demographics
NPI:1114023132
Name:KALY PSYCHOLOGICAL SERVICES INC
Entity Type:Organization
Organization Name:KALY PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KALY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:813-486-0398
Mailing Address - Street 1:12169 W. LINEBAUGH AVE.
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-1732
Mailing Address - Country:US
Mailing Address - Phone:813-486-0398
Mailing Address - Fax:813-891-6016
Practice Address - Street 1:12169 W. LINEBAUGH AVE.
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-1732
Practice Address - Country:US
Practice Address - Phone:813-486-0398
Practice Address - Fax:813-891-6016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6377103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty