Provider Demographics
NPI:1669794301
Name:PSYCHOLOGICS PC
Entity type:Organization
Organization Name:PSYCHOLOGICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MERRIFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-203-9563
Mailing Address - Street 1:8011 CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3533
Mailing Address - Country:US
Mailing Address - Phone:402-203-9563
Mailing Address - Fax:402-345-2376
Practice Address - Street 1:8011 CHICAGO ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3533
Practice Address - Country:US
Practice Address - Phone:402-203-9563
Practice Address - Fax:402-345-2376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE738103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Single Specialty