Provider Demographics
NPI:1427417880
Name:LORD PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:LORD PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:P
Authorized Official - Last Name:LORD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:425-200-5582
Mailing Address - Street 1:826 102ND AVE NE
Mailing Address - Street 2:#400
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4162
Mailing Address - Country:US
Mailing Address - Phone:425-200-5582
Mailing Address - Fax:
Practice Address - Street 1:826 102ND AVE NE
Practice Address - Street 2:#400
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4162
Practice Address - Country:US
Practice Address - Phone:425-200-5582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-14
Last Update Date:2016-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty