Provider Demographics
NPI:1639354046
Name:CONSULTING PSYCHOLOGISTS
Entity Type:Organization
Organization Name:CONSULTING PSYCHOLOGISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:R
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:817-909-7995
Mailing Address - Street 1:1215 HALL JOHNSON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-7810
Mailing Address - Country:US
Mailing Address - Phone:817-909-7995
Mailing Address - Fax:817-428-9885
Practice Address - Street 1:1215 HALL JOHNSON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-7810
Practice Address - Country:US
Practice Address - Phone:817-909-7995
Practice Address - Fax:817-428-9885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33275103TC0700X
TX33305103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty