Provider Demographics
NPI:1245995273
Name:PSYCHOLOGY TELEHEALTH SERVICES, LLC
Entity type:Organization
Organization Name:PSYCHOLOGY TELEHEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-461-4504
Mailing Address - Street 1:820 RESERVE CHAMPION DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5877
Mailing Address - Country:US
Mailing Address - Phone:301-461-4504
Mailing Address - Fax:
Practice Address - Street 1:820 RESERVE CHAMPION DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5877
Practice Address - Country:US
Practice Address - Phone:301-461-4504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty