Provider Demographics
NPI:1679635114
Name:PSYCHOLOGICAL HEALTH SERVICES PA
Entity Type:Organization
Organization Name:PSYCHOLOGICAL HEALTH SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:609-396-3491
Mailing Address - Street 1:363 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08609-2716
Mailing Address - Country:US
Mailing Address - Phone:609-396-3491
Mailing Address - Fax:
Practice Address - Street 1:363 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08609-2716
Practice Address - Country:US
Practice Address - Phone:609-396-3491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00178800103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty