Provider Demographics
NPI:1295138964
Name:OVERTON PSYCHOLOGICAL SERVICES, PLLC
Entity type:Organization
Organization Name:OVERTON PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTI
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-563-1000
Mailing Address - Street 1:8975 S PECOS RD
Mailing Address - Street 2:SUITE 8D
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7160
Mailing Address - Country:US
Mailing Address - Phone:702-563-1000
Mailing Address - Fax:702-563-1001
Practice Address - Street 1:8975 S PECOS RD
Practice Address - Street 2:SUITE 8D
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7160
Practice Address - Country:US
Practice Address - Phone:702-563-1000
Practice Address - Fax:702-563-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health