Provider Demographics
NPI:1609051093
Name:ADVANCED PSYCHOLOGICAL ALTERNATIVES, INC
Entity Type:Organization
Organization Name:ADVANCED PSYCHOLOGICAL ALTERNATIVES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRITZALIS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-212-3335
Mailing Address - Street 1:15010 S RAVINIA AVE
Mailing Address - Street 2:#314
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3162
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15010 S RAVINIA AVE
Practice Address - Street 2:#314
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3162
Practice Address - Country:US
Practice Address - Phone:708-212-3335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Single Specialty