Provider Demographics
NPI:1326172479
Name:ADVANCED PSYCHOLOGICAL SERVICES,LLC
Entity Type:Organization
Organization Name:ADVANCED PSYCHOLOGICAL SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SOLLITTO
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:732-780-0347
Mailing Address - Street 1:94 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2133
Mailing Address - Country:US
Mailing Address - Phone:732-780-0347
Mailing Address - Fax:732-780-0346
Practice Address - Street 1:94 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2133
Practice Address - Country:US
Practice Address - Phone:732-780-0347
Practice Address - Fax:732-780-0346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100163500103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1477568236OtherNPI
NJ1386783058OtherNPI
NJ1477568236OtherNPI