Provider Demographics
NPI:1497874143
Name:PSYCHOLOGICAL DEVELOPMENT SERVICES
Entity Type:Organization
Organization Name:PSYCHOLOGICAL DEVELOPMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:KHALILI
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:913-782-4996
Mailing Address - Street 1:413 E SANTA FE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-3445
Mailing Address - Country:US
Mailing Address - Phone:913-782-4996
Mailing Address - Fax:913-782-4997
Practice Address - Street 1:413 E SANTA FE ST
Practice Address - Street 2:SUITE B
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-3445
Practice Address - Country:US
Practice Address - Phone:913-782-4996
Practice Address - Fax:913-782-4997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS275103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty