Provider Demographics
NPI:1184234718
Name:SYNCHRONY PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:SYNCHRONY PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:WOLCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-579-0156
Mailing Address - Street 1:100 N MORAIN ST STE 206
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2905
Mailing Address - Country:US
Mailing Address - Phone:509-579-0156
Mailing Address - Fax:509-491-3112
Practice Address - Street 1:100 N MORAIN ST STE 206
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2905
Practice Address - Country:US
Practice Address - Phone:509-579-0156
Practice Address - Fax:509-491-3112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-07
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health