Provider Demographics
NPI:1265130108
Name:FETCH HELP PSYCHOLOGICAL SERVICES PLLC
Entity type:Organization
Organization Name:FETCH HELP PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TROUT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, JD, MSED
Authorized Official - Phone:929-262-0672
Mailing Address - Street 1:800 3RD AVE FRNT A1183
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-7649
Mailing Address - Country:US
Mailing Address - Phone:929-262-0674
Mailing Address - Fax:
Practice Address - Street 1:800 3RD AVE FRNT A1183
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-7649
Practice Address - Country:US
Practice Address - Phone:929-262-0674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty