Provider Demographics
NPI:1831812684
Name:INPSYCH EVALUATION SERVICES LLC
Entity type:Organization
Organization Name:INPSYCH EVALUATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DMYTRYSZYN
Authorized Official - Suffix:
Authorized Official - Credentials:MS LLP
Authorized Official - Phone:734-626-1824
Mailing Address - Street 1:2304 PROGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48146-4808
Mailing Address - Country:US
Mailing Address - Phone:734-626-1824
Mailing Address - Fax:
Practice Address - Street 1:2836 W JEFFERSON AVE STE 109
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2902
Practice Address - Country:US
Practice Address - Phone:313-389-6153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)