Provider Demographics
NPI:1023428463
Name:FAMILY PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:FAMILY PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:E
Authorized Official - Last Name:THIGPEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:318-998-2700
Mailing Address - Street 1:1818 AVENUE OF AMERICA
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-4530
Mailing Address - Country:US
Mailing Address - Phone:318-998-2700
Mailing Address - Fax:318-998-2703
Practice Address - Street 1:1818 AVENUE OF AMERICA
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-4530
Practice Address - Country:US
Practice Address - Phone:318-998-2700
Practice Address - Fax:318-998-2703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA476103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty