Provider Demographics
NPI:1164980751
Name:CGM PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:CGM PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:GREFE MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:908-797-7981
Mailing Address - Street 1:306 4TH AVE APT 901
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-2008
Mailing Address - Country:US
Mailing Address - Phone:908-797-7981
Mailing Address - Fax:
Practice Address - Street 1:33 TERMINAL WAY STE 525A
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-1216
Practice Address - Country:US
Practice Address - Phone:724-299-1848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1699142265Medicaid