Provider Demographics
NPI:1952460008
Name:PSYCHOLOIGICAL & FAMILY CONSULTANTS, INC.
Entity Type:Organization
Organization Name:PSYCHOLOIGICAL & FAMILY CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:K
Authorized Official - Last Name:DEVIES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:330-493-4220
Mailing Address - Street 1:4572 DRESSLER RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2546
Mailing Address - Country:US
Mailing Address - Phone:330-493-4220
Mailing Address - Fax:330-493-8850
Practice Address - Street 1:4572 DRESSLER RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2546
Practice Address - Country:US
Practice Address - Phone:330-493-4220
Practice Address - Fax:330-493-8850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000172000OtherMAGELLAN
OH2189242Medicaid
OH000172000OtherMAGELLAN
OH000172000OtherMAGELLAN
OH9239951Medicare ID - Type Unspecified