Provider Demographics
NPI:1407268782
Name:CEDARS PSYCHOLOGY SERVICES, LLC
Entity Type:Organization
Organization Name:CEDARS PSYCHOLOGY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNEY-MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:360-836-0493
Mailing Address - Street 1:3711 MAYBERRY RD
Mailing Address - Street 2:
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531-1573
Mailing Address - Country:US
Mailing Address - Phone:360-836-0493
Mailing Address - Fax:
Practice Address - Street 1:221 N TOWER AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-4309
Practice Address - Country:US
Practice Address - Phone:360-836-0493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60448678251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health