Provider Demographics
NPI:1326290107
Name:TKPSYC SERVICES, LLC
Entity Type:Organization
Organization Name:TKPSYC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TEROME
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:301-725-7356
Mailing Address - Street 1:1005 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3810
Mailing Address - Country:US
Mailing Address - Phone:301-725-7356
Mailing Address - Fax:301-725-7356
Practice Address - Street 1:1005 8TH ST
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-3810
Practice Address - Country:US
Practice Address - Phone:301-725-7356
Practice Address - Fax:301-725-7356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-12
Last Update Date:2008-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDW12488898251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health