Provider Demographics
NPI:1831211580
Name:PSYCHOLOGY SERVICES, INCORPORATED
Entity type:Organization
Organization Name:PSYCHOLOGY SERVICES, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KARSTENS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, MA
Authorized Official - Phone:708-349-4455
Mailing Address - Street 1:15040 S RAVINIA AVE
Mailing Address - Street 2:SUITE 49
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3194
Mailing Address - Country:US
Mailing Address - Phone:708-349-4455
Mailing Address - Fax:708-349-6448
Practice Address - Street 1:15040 S RAVINIA AVE
Practice Address - Street 2:SUITE 49
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3194
Practice Address - Country:US
Practice Address - Phone:708-349-4455
Practice Address - Fax:708-349-6448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-005827101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty