Provider Demographics
NPI:1578960753
Name:NASH PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:NASH PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:GUIDULI
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:802-598-3636
Mailing Address - Street 1:277 BLAIR PARK RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-7886
Mailing Address - Country:US
Mailing Address - Phone:802-598-3636
Mailing Address - Fax:802-316-4208
Practice Address - Street 1:277 BLAIR PARK RD
Practice Address - Street 2:SUITE 210
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-7886
Practice Address - Country:US
Practice Address - Phone:802-598-3636
Practice Address - Fax:802-316-4208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty