Provider Demographics
NPI:1619201209
Name:NORTHWEST PSYCHOLOGICAL SERVICES, PC
Entity Type:Organization
Organization Name:NORTHWEST PSYCHOLOGICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:NADASI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:406-471-6312
Mailing Address - Street 1:723 5TH AVE E STE 110C
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-5325
Mailing Address - Country:US
Mailing Address - Phone:406-212-8309
Mailing Address - Fax:406-257-9358
Practice Address - Street 1:723 5TH AVE E STE 110C
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-5325
Practice Address - Country:US
Practice Address - Phone:406-212-8309
Practice Address - Fax:406-257-9358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health