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General NPI Number Information
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NPI Number | 1336354349
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGY CONSULTANTS ASSOC
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Dates
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Enumeration Date | 05/12/2007
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 1205 YORK RD
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City | LUTHERVILLE
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State | MD
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Zip | 21093-6210
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Country | US
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Telephone | 410-998-3920
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Fax | 410-998-3931
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Provider Business Mailing Address
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Address Line | 11421 CRONHILL DR
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City | OWINGS MILLS
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State | MD
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Zip | 21117-2222
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Country | US
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Telephone | 410-998-3920
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Fax | 410-998-3931
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Authorized Official
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Title or Position | BILLING MGR
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Name | LOUISE MACY
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Credential |
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Telephone | 410-998-3920
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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 | 00457
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License Number State | MD
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