Provider Demographics
NPI:1275680001
Name:PSYCHOSOCIAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:PSYCHOSOCIAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:HARLAN
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:419-659-5998
Mailing Address - Street 1:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS GROVE
Mailing Address - State:OH
Mailing Address - Zip Code:45830-0176
Mailing Address - Country:US
Mailing Address - Phone:419-659-5998
Mailing Address - Fax:419-659-2083
Practice Address - Street 1:200 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS GROVE
Practice Address - State:OH
Practice Address - Zip Code:45830-1205
Practice Address - Country:US
Practice Address - Phone:419-659-5998
Practice Address - Fax:419-659-2083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty