Provider Demographics
NPI:1114524337
Name:T PSYCHOLOGICAL SERVICES PROFESSIONAL LLC
Entity Type:Organization
Organization Name:T PSYCHOLOGICAL SERVICES PROFESSIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOEWS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:857-201-0170
Mailing Address - Street 1:304 AVALON DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-2067
Mailing Address - Country:US
Mailing Address - Phone:857-201-0170
Mailing Address - Fax:
Practice Address - Street 1:305 AVALON DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-2067
Practice Address - Country:US
Practice Address - Phone:857-201-0170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty