Provider Demographics
NPI:1982646428
Name:COMPREHENSIVE PSYCHOLOGICAL SERVICES PC
Entity Type:Organization
Organization Name:COMPREHENSIVE PSYCHOLOGICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:D
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:865-525-1099
Mailing Address - Street 1:108 WEST SUMMIT HILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37902
Mailing Address - Country:US
Mailing Address - Phone:865-525-1099
Mailing Address - Fax:865-525-7494
Practice Address - Street 1:108 WEST SUMMIT HILL DRIVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37902
Practice Address - Country:US
Practice Address - Phone:865-525-1099
Practice Address - Fax:865-525-7494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP1947103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3982642Medicaid
TN4056695OtherBCBS TN
TN4056695OtherBCBS TN