Provider Demographics
NPI:1396250700
Name:PULASKI COUNTY PUBLIC SCHOOLS
Entity type:Organization
Organization Name:PULASKI COUNTY PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SIERS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:540-994-2519
Mailing Address - Street 1:202 NORTH WASHINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:VA
Mailing Address - Zip Code:24301
Mailing Address - Country:US
Mailing Address - Phone:540-994-2544
Mailing Address - Fax:540-994-2560
Practice Address - Street 1:202 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:VA
Practice Address - Zip Code:24301-5022
Practice Address - Country:US
Practice Address - Phone:540-994-2544
Practice Address - Fax:540-994-2560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0813000169103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty