Provider Demographics
NPI:1114234853
Name:PSYCHOLOGICAL EVALUATIONS AND CONSULTING, LLC
Entity Type:Organization
Organization Name:PSYCHOLOGICAL EVALUATIONS AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:DEBENEDETTO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-244-0755
Mailing Address - Street 1:66 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507-1800
Mailing Address - Country:US
Mailing Address - Phone:914-244-0755
Mailing Address - Fax:
Practice Address - Street 1:66 MAIN ST
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507-1800
Practice Address - Country:US
Practice Address - Phone:914-244-0755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008548-1103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty