Provider Demographics
NPI:1821236670
Name:PSYCHOLOGICAL CONSULTING SERVICE PSC
Entity Type:Organization
Organization Name:PSYCHOLOGICAL CONSULTING SERVICE PSC
Other - Org Name:PSYCHOLOGICAL CONSULTING SERVICE PSC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADALEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-395-7068
Mailing Address - Street 1:#715 CALLE MEDITERRANEO
Mailing Address - Street 2:URB. PASEO LOS CORALES II
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-395-7068
Mailing Address - Fax:
Practice Address - Street 1:715 CALLE MEDITERRANEO
Practice Address - Street 2:PASEO LOS CORALES II
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-9998
Practice Address - Country:US
Practice Address - Phone:787-395-7068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-02
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRS63117Medicare UPIN
PR89241SIMedicare PIN