Healthcare Provider Details
I. General information
NPI: 1114860152
Provider Name (Legal Business Name): P.S. PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2142 SHERWOOD LN
HAVRE DE GRACE MD
21078-2014
US
IV. Provider business mailing address
2142 SHERWOOD LN
HAVRE DE GRACE MD
21078-2014
US
V. Phone/Fax
- Phone: 443-255-4638
- Fax:
- Phone: 443-255-4638
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PERRI
JOSEPHINE
SCOTT
Title or Position: OWNER
Credential: LCPC
Phone: 443-255-4638