Provider Demographics
NPI:1902198120
Name:PSYCHOLOGICAL ASSOCIATES INC.
Entity Type:Organization
Organization Name:PSYCHOLOGICAL ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MUNCY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-235-2000
Mailing Address - Street 1:2699 E MAIN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2533
Mailing Address - Country:US
Mailing Address - Phone:614-235-2000
Mailing Address - Fax:
Practice Address - Street 1:3120 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-3707
Practice Address - Country:US
Practice Address - Phone:614-235-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0004118101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2383586Medicaid
OH2383586Medicaid