Provider Demographics
NPI:1972060788
Name:PSY-CHE PLLC
Entity Type:Organization
Organization Name:PSY-CHE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:PERAINO
Authorized Official - Last Name:SMOOTS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA LMSW
Authorized Official - Phone:248-765-8343
Mailing Address - Street 1:22445 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-2360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22445 MAPLE ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2360
Practice Address - Country:US
Practice Address - Phone:248-765-8343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty