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General NPI Number Information
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NPI Number | 1598539280
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL SERVICES FOR SUCCESS
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 5290 OVERPASS RD STE 220
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City | SANTA BARBARA
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State | CA
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Zip | 93111-2051
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Country | US
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Telephone | 805-403-3445
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Fax |
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Provider Business Mailing Address
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Address Line | 5290 OVERPASS RD STE 118
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City | SANTA BARBARA
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State | CA
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Zip | 93111-2049
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Country | US
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Telephone | 805-403-3445
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Fax |
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Authorized Official
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Title or Position | LICENSED EDUCATIONAL PSYCHOLOGIST
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Name | KAITLYN BATHEL
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Credential | M.ED., LEP
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Telephone | 805-403-3445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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