Provider Demographics
NPI:1700409117
Name:SPRINGTOWN PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:SPRINGTOWN PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED CLINICAL PSYCHOLOGIS
Authorized Official - Prefix:DR
Authorized Official - First Name:GENEVIEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:REICH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:856-200-8363
Mailing Address - Street 1:2435 CARA CT
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-8780
Mailing Address - Country:US
Mailing Address - Phone:856-200-8363
Mailing Address - Fax:
Practice Address - Street 1:4403 BIRKLAND PL # 1013
Practice Address - Street 2:
Practice Address - City:TATAMY BOROUGH
Practice Address - State:PA
Practice Address - Zip Code:18045-4701
Practice Address - Country:US
Practice Address - Phone:856-200-8363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty