Provider Demographics
NPI:1164292223
Name:SUPERIOR PSYCH ASSESSMENT SERVICES LLC
Entity Type:Organization
Organization Name:SUPERIOR PSYCH ASSESSMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TALLI
Authorized Official - Middle Name:
Authorized Official - Last Name:HITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-688-6112
Mailing Address - Street 1:400 S MCCASLIN BLVD STE 121
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9701
Mailing Address - Country:US
Mailing Address - Phone:970-688-6112
Mailing Address - Fax:
Practice Address - Street 1:400 S MCCASLIN BLVD STE 121
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-9701
Practice Address - Country:US
Practice Address - Phone:970-688-6112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty