Provider Demographics
NPI:1922138031
Name:PSYCHOLOGICAL SERVICES OF DANVILLE, PLLC
Entity Type:Organization
Organization Name:PSYCHOLOGICAL SERVICES OF DANVILLE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUANN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-238-9469
Mailing Address - Street 1:1024 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-3609
Mailing Address - Country:US
Mailing Address - Phone:859-238-9469
Mailing Address - Fax:
Practice Address - Street 1:1024 HIGH ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-3609
Practice Address - Country:US
Practice Address - Phone:859-238-9469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Multi-Specialty