Provider Demographics
NPI:1558722926
Name:PSYCHOLOGICAL CONSULTING SERVICES
Entity Type:Organization
Organization Name:PSYCHOLOGICAL CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SOCIEDADE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:973-491-0773
Mailing Address - Street 1:182 VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-2638
Mailing Address - Country:US
Mailing Address - Phone:973-491-0773
Mailing Address - Fax:
Practice Address - Street 1:182 VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-2638
Practice Address - Country:US
Practice Address - Phone:973-491-0773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAULA C. SOCIEDADE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3664103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty