Provider Demographics
NPI:1851514277
Name:APPLIED PSYCHOLOGY CENTER, PC
Entity Type:Organization
Organization Name:APPLIED PSYCHOLOGY CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEFAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:228-861-0167
Mailing Address - Street 1:904 DESOTO ST
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3737
Mailing Address - Country:US
Mailing Address - Phone:228-872-8429
Mailing Address - Fax:228-872-0226
Practice Address - Street 1:904 DESOTO ST
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3737
Practice Address - Country:US
Practice Address - Phone:228-872-8429
Practice Address - Fax:228-872-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty