Provider Demographics
NPI:1740337468
Name:PSYCHOLOGICAL SERVICES AND CHRONIC PAIN MANAGEMENT INC.
Entity type:Organization
Organization Name:PSYCHOLOGICAL SERVICES AND CHRONIC PAIN MANAGEMENT INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MONIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUMB
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:618-529-2273
Mailing Address - Street 1:800 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-2538
Mailing Address - Country:US
Mailing Address - Phone:618-529-2273
Mailing Address - Fax:618-549-8321
Practice Address - Street 1:800 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-2538
Practice Address - Country:US
Practice Address - Phone:618-529-2273
Practice Address - Fax:618-549-8321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty