Provider Demographics
NPI:1659847085
Name:SYNERGISTIC PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:SYNERGISTIC PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SWATI
Authorized Official - Middle Name:
Authorized Official - Last Name:MARNER
Authorized Official - Suffix:
Authorized Official - Credentials:ED D
Authorized Official - Phone:267-587-7492
Mailing Address - Street 1:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-0034
Mailing Address - Country:US
Mailing Address - Phone:267-587-7492
Mailing Address - Fax:
Practice Address - Street 1:302 BIRCHFIELD DR
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-4005
Practice Address - Country:US
Practice Address - Phone:267-587-7492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)