Provider Demographics
NPI:1932754595
Name:PSYCHOLOGICAL SERVICES P.A.
Entity Type:Organization
Organization Name:PSYCHOLOGICAL SERVICES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:215-764-2403
Mailing Address - Street 1:715 SCOTT LN
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6734
Mailing Address - Country:US
Mailing Address - Phone:215-764-2403
Mailing Address - Fax:
Practice Address - Street 1:850 LIBRARY AVE STE 104
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7170
Practice Address - Country:US
Practice Address - Phone:302-724-6662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PSYCHOLOGICAL SERVICES P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty