Healthcare Provider Details

I. General information

NPI: 1982499729
Provider Name (Legal Business Name): PSYD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 PHILADELPHIA PIKE
WILMINGTON DE
19809-2042
US

IV. Provider business mailing address

1201 PHILADELPHIA PIKE
WILMINGTON DE
19809-2042
US

V. Phone/Fax

Practice location:
  • Phone: 302-798-4400
  • Fax: 302-708-3002
Mailing address:
  • Phone: 302-798-4400
  • Fax: 302-798-3002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CALVIN E WOODLAND
Title or Position: OWNER
Credential: PSYD LLC
Phone: 302-798-4400