Provider Demographics
NPI:1528379278
Name:PSYCHOLOGICAL & EDUCATIONAL SERVICES, LLC
Entity Type:Organization
Organization Name:PSYCHOLOGICAL & EDUCATIONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PH.D/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHIPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-398-2434
Mailing Address - Street 1:1351 S COUNTY TRL
Mailing Address - Street 2:110
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-5079
Mailing Address - Country:US
Mailing Address - Phone:401-398-2434
Mailing Address - Fax:401-398-2451
Practice Address - Street 1:1351 S COUNTY TRL
Practice Address - Street 2:110
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-5079
Practice Address - Country:US
Practice Address - Phone:401-398-2434
Practice Address - Fax:401-398-2451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01069103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty