Provider Demographics
NPI:1508298555
Name:PIEDMONT PSYCHOLOGICAL PRACTICE LLC
Entity Type:Organization
Organization Name:PIEDMONT PSYCHOLOGICAL PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:ASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:307-672-2468
Mailing Address - Street 1:1408 ODELL CT UNIT C
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-4449
Mailing Address - Country:US
Mailing Address - Phone:307-672-4689
Mailing Address - Fax:307-672-2469
Practice Address - Street 1:1408 ODELL CT UNIT C
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-4449
Practice Address - Country:US
Practice Address - Phone:307-672-4689
Practice Address - Fax:307-672-2469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty