Provider Demographics
NPI:1790886075
Name:ABINGDON PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:ABINGDON PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:DARRELL
Authorized Official - Last Name:RAMSDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:276-676-1177
Mailing Address - Street 1:P.O. BOX 1535
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24212-1535
Mailing Address - Country:US
Mailing Address - Phone:276-676-1177
Mailing Address - Fax:276-676-1027
Practice Address - Street 1:845 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-4414
Practice Address - Country:US
Practice Address - Phone:276-676-1177
Practice Address - Fax:276-676-1027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10179Medicare PIN