Provider Demographics
NPI:1508374133
Name:CLINICAL HEALTH PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:CLINICAL HEALTH PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:AMODIO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:732-800-1486
Mailing Address - Street 1:665 COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6431
Mailing Address - Country:US
Mailing Address - Phone:732-800-1486
Mailing Address - Fax:
Practice Address - Street 1:665 COMMONS WAY
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6431
Practice Address - Country:US
Practice Address - Phone:732-800-1486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100555900261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health