Provider Demographics
NPI:1417618042
Name:ACME PSYCHOLOGY, INC.
Entity Type:Organization
Organization Name:ACME PSYCHOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:CRAWSHAW
Authorized Official - Last Name:PSY.D.
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-345-5387
Mailing Address - Street 1:3151 AIRWAY AVE STE K205
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4636
Mailing Address - Country:US
Mailing Address - Phone:949-345-5387
Mailing Address - Fax:
Practice Address - Street 1:3151 AIRWAY AVE STE K205
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4636
Practice Address - Country:US
Practice Address - Phone:949-345-5387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty