Provider Demographics
NPI:1992865638
Name:L.I. PSYCHOLOGICAL COUNSELING SERVICES, P.C.
Entity Type:Organization
Organization Name:L.I. PSYCHOLOGICAL COUNSELING SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-317-7696
Mailing Address - Street 1:136 MURRAY HILL DRIVE
Mailing Address - Street 2:#27
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-4226
Mailing Address - Country:US
Mailing Address - Phone:802-223-0491
Mailing Address - Fax:802-223-0491
Practice Address - Street 1:136 MURRAY HILL DRIVE
Practice Address - Street 2:#27
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-4226
Practice Address - Country:US
Practice Address - Phone:802-223-0491
Practice Address - Fax:802-223-0491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT849103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty