Provider Demographics
NPI:1780393876
Name:DR MAYSONET CLINICAL & FORENSIC PSYCHOLOGY FIRM PLLC
Entity type:Organization
Organization Name:DR MAYSONET CLINICAL & FORENSIC PSYCHOLOGY FIRM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MADELINE
Authorized Official - Middle Name:IVETTE
Authorized Official - Last Name:MAYSONET SCAVO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:570-939-2282
Mailing Address - Street 1:2796 HOMESTEAD DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-8640
Mailing Address - Country:US
Mailing Address - Phone:570-939-2822
Mailing Address - Fax:
Practice Address - Street 1:1275 GLENLIVET DR STE 100
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-3107
Practice Address - Country:US
Practice Address - Phone:570-939-2282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty