Provider Demographics
NPI:1528384831
Name:PEDIATRIC SCHOOL PSYCHOLOGY: EVALUATION AND CONSULTATION SERVICES
Entity Type:Organization
Organization Name:PEDIATRIC SCHOOL PSYCHOLOGY: EVALUATION AND CONSULTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:CHESNO
Authorized Official - Last Name:GRIER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, NCSP
Authorized Official - Phone:803-309-5231
Mailing Address - Street 1:3612 LANDMARK DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-4039
Mailing Address - Country:US
Mailing Address - Phone:803-309-5231
Mailing Address - Fax:803-782-1420
Practice Address - Street 1:3612 LANDMARK DR
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-4039
Practice Address - Country:US
Practice Address - Phone:803-309-5231
Practice Address - Fax:803-782-1420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC848103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty