Provider Demographics
NPI:1790145209
Name:PSYCHOTHERAPEUTIC SERVICES INC
Entity Type:Organization
Organization Name:PSYCHOTHERAPEUTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:410-810-2468
Mailing Address - Street 1:870 HIGH STREET
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620
Mailing Address - Country:US
Mailing Address - Phone:410-788-1099
Mailing Address - Fax:
Practice Address - Street 1:1420 MCKEE RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-1378
Practice Address - Country:US
Practice Address - Phone:302-257-5828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PSI MENS SUD RESIDENTIAL HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-25
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder