Provider Demographics
NPI:1215363536
Name:RX PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:RX PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DARAKJY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:915-588-0223
Mailing Address - Street 1:708 ROSINANTE RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-2904
Mailing Address - Country:US
Mailing Address - Phone:915-588-0223
Mailing Address - Fax:915-231-6111
Practice Address - Street 1:5300 MCNUTT RD
Practice Address - Street 2:SUITE 12
Practice Address - City:SANTA TERESA
Practice Address - State:NM
Practice Address - Zip Code:88008-9606
Practice Address - Country:US
Practice Address - Phone:575-332-9138
Practice Address - Fax:915-231-6111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1267251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health