Provider Demographics
NPI:1558775510
Name:PSEEKOS, NATE CHANTELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:NATE
Middle Name:CHANTELLE
Last Name:PSEEKOS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:AIMEE
Other - Middle Name:CHANTELLE
Other - Last Name:PSEEKOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:112 CAPRON FARM DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7704
Mailing Address - Country:US
Mailing Address - Phone:937-367-7901
Mailing Address - Fax:855-208-9250
Practice Address - Street 1:112 CAPRON FARM DR
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7704
Practice Address - Country:US
Practice Address - Phone:937-367-7901
Practice Address - Fax:855-208-9250
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01259103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103T00000XBehavioral Health & Social Service ProvidersPsychologist