Healthcare Provider Details
I. General information
NPI: 1275680001
Provider Name (Legal Business Name): PSYCHOSOCIAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/04/2007
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
204 N HIGH ST
COLUMBUS GROVE OH
45830-1205
US
IV. Provider business mailing address
PO BOX 176
COLUMBUS GROVE OH
45830-0176
US
V. Phone/Fax
- Phone: 419-659-5998
- Fax: 419-659-2083
- Phone: 419-659-5998
- Fax: 419-659-2083
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BARRY
MCCRATE
BECKMAN
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 419-659-5998