Provider Demographics
NPI:1346457322
Name:PSYCHOLOGICAL SERVICES OF ORANGE COUNTY, P.C.
Entity Type:Organization
Organization Name:PSYCHOLOGICAL SERVICES OF ORANGE COUNTY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-294-8741
Mailing Address - Street 1:PO BOX 841
Mailing Address - Street 2:28 MCBRIDE PLACE
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-0841
Mailing Address - Country:US
Mailing Address - Phone:845-294-8741
Mailing Address - Fax:845-294-5337
Practice Address - Street 1:28 MCBRIDE PLACE
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-2107
Practice Address - Country:US
Practice Address - Phone:845-294-8741
Practice Address - Fax:845-294-5337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4226103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty