Provider Demographics
NPI:1639538770
Name:BRILEY PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:BRILEY PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRILEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:325-215-4606
Mailing Address - Street 1:2222 HIGHWAY 377 S
Mailing Address - Street 2:SUITE 9
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-3905
Mailing Address - Country:US
Mailing Address - Phone:325-215-4606
Mailing Address - Fax:325-215-4606
Practice Address - Street 1:2222 HIGHWAY 377 S
Practice Address - Street 2:SUITE 9
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-3905
Practice Address - Country:US
Practice Address - Phone:325-215-4606
Practice Address - Fax:325-215-4606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36016103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX302547002Medicaid
TX302547002Medicaid