Healthcare Provider Details

I. General information

NPI: 1790145209
Provider Name (Legal Business Name): PSYCHOTHERAPEUTIC SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2016
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 MCKEE RD
DOVER DE
19904-1378
US

IV. Provider business mailing address

104 SPRING AVE UNIT 299
CHESTERTOWN MD
21620-8512
US

V. Phone/Fax

Practice location:
  • Phone: 302-257-5828
  • Fax:
Mailing address:
  • Phone: 410-788-1099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIN OLIVER
Title or Position: TREASURER & CONTROLLER
Credential:
Phone: 410-778-1099