Provider Demographics
NPI:1508920240
Name:C.T. PSYCHOLOGIST, PPLC
Entity Type:Organization
Organization Name:C.T. PSYCHOLOGIST, PPLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARABAJAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:480-726-2600
Mailing Address - Street 1:793 N ALMA SCHOOL RD
Mailing Address - Street 2:SUITE C # 10
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-3681
Mailing Address - Country:US
Mailing Address - Phone:480-726-2600
Mailing Address - Fax:480-726-2200
Practice Address - Street 1:793 N ALMA SCHOOL RD
Practice Address - Street 2:SUITE C # 10
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-3681
Practice Address - Country:US
Practice Address - Phone:480-726-2600
Practice Address - Fax:480-726-2200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1868103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty