Provider Demographics
NPI:1578113601
Name:RENO PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:RENO PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:CRUM
Authorized Official - Suffix:
Authorized Official - Credentials:PSY,D,
Authorized Official - Phone:775-657-9597
Mailing Address - Street 1:645 PLUMAS ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-1730
Mailing Address - Country:US
Mailing Address - Phone:775-657-9597
Mailing Address - Fax:775-562-7570
Practice Address - Street 1:645 PLUMAS ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-1730
Practice Address - Country:US
Practice Address - Phone:775-657-9597
Practice Address - Fax:775-562-7570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health