Provider Demographics
NPI:1982234340
Name:CIL PSYCHOLOGICAL SERVICES PLLC
Entity Type:Organization
Organization Name:CIL PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:INMON LONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-523-0200
Mailing Address - Street 1:1079 W ROUND GROVE RD STE 300-350
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-7905
Mailing Address - Country:US
Mailing Address - Phone:972-523-0200
Mailing Address - Fax:
Practice Address - Street 1:3740 N JOSEY LN STE 246
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2509
Practice Address - Country:US
Practice Address - Phone:972-523-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty