Provider Demographics
NPI:1932698875
Name:COMPREHENSIVE PSYCHOLOGY SERVICES LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PSYCHOLOGY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:575-574-0267
Mailing Address - Street 1:PO BOX 1641
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88062-1641
Mailing Address - Country:US
Mailing Address - Phone:575-574-0267
Mailing Address - Fax:575-388-1035
Practice Address - Street 1:508 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-4925
Practice Address - Country:US
Practice Address - Phone:575-574-0267
Practice Address - Fax:575-388-1035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1210103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty