Provider Demographics
NPI:1639409949
Name:CHESTER PSYCHOLOGICAL SERVICES, PA
Entity Type:Organization
Organization Name:CHESTER PSYCHOLOGICAL SERVICES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-879-7132
Mailing Address - Street 1:PO BOX 629
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930-0629
Mailing Address - Country:US
Mailing Address - Phone:908-879-7132
Mailing Address - Fax:908-955-4339
Practice Address - Street 1:10 SCHOOLHOUSE LN
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-3205
Practice Address - Country:US
Practice Address - Phone:908-879-7132
Practice Address - Fax:908-955-4339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1959261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center