Provider Demographics
NPI:1790919090
Name:LINK PSYCHOLOGICAL SERVICES, PC
Entity Type:Organization
Organization Name:LINK PSYCHOLOGICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:LINK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:701-223-3571
Mailing Address - Street 1:1424 W CENTURY AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0917
Mailing Address - Country:US
Mailing Address - Phone:701-223-3571
Mailing Address - Fax:701-751-2352
Practice Address - Street 1:1424 W CENTURY AVE STE 207
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0917
Practice Address - Country:US
Practice Address - Phone:701-223-3571
Practice Address - Fax:701-751-2352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND425103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND10378OtherND MEDICAID NUMBER FOR JAMES LINK, PSY.D., L.P.
ND10380OtherND MEDICAID NUMBER FOR LINK PSYCHOLOGICAL SERVICES, PC