Provider Demographics
NPI:1831234103
Name:ADULT AND CHILD PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:ADULT AND CHILD PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EDUCATIONAL CONSULTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:706-322-8264
Mailing Address - Street 1:1501 13TH ST
Mailing Address - Street 2:SUITE J
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-2383
Mailing Address - Country:US
Mailing Address - Phone:706-322-8264
Mailing Address - Fax:706-322-5858
Practice Address - Street 1:1501 13TH ST
Practice Address - Street 2:SUITE J
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2383
Practice Address - Country:US
Practice Address - Phone:706-322-8264
Practice Address - Fax:706-322-5858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA992103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1821187360OtherPSYCHOLOGY