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General NPI Number Information
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NPI Number | 1063595262
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Entity Type | Organization
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Legal Business Name | COUNSELAID PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6476 ADOBE ROAD
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City | TWENTYNINE PALMS
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State | CA
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Zip | 92277
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Country | US
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Telephone | 760-367-6198
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Fax | 760-367-0418
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Provider Business Mailing Address
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Address Line | PO BOX 1716
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City | TWENTYNINE PALMS
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State | CA
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Zip | 92277-1000
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Country | US
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Telephone | 760-367-6198
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Fax | 760-367-0418
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL F BARKMAN
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Credential | PHD
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Telephone | 760-367-6198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY2912
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License Number State | CA
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