Provider Demographics
NPI:1679735450
Name:COMPREHENSIVE PSYCHOLOGICAL SERVICES, LTD.
Entity Type:Organization
Organization Name:COMPREHENSIVE PSYCHOLOGICAL SERVICES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHMUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:803-724-7924
Mailing Address - Street 1:845 COUNTY HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-8015
Mailing Address - Country:US
Mailing Address - Phone:803-724-7924
Mailing Address - Fax:325-701-9199
Practice Address - Street 1:845 COUNTY HOUSE LN
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-8015
Practice Address - Country:US
Practice Address - Phone:803-724-7924
Practice Address - Fax:325-701-9199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X, 363LP0808X
TX37508103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2778383Medicaid
OH2775340Medicaid
OH2775340Medicaid