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General NPI Number Information
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NPI Number | 1659791440
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Entity Type | Organization
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Legal Business Name | DELAWARE PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 04/21/2014
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Last Update Date | 04/21/2014
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Provider Practice Location Address
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Address Line | 17021 OLD ORCHARD RD SUITE 4
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City | LEWES
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State | DE
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Zip | 19958-4832
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Country | US
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Telephone | 609-517-1529
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Fax |
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Provider Business Mailing Address
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Address Line | 27387 WALKING RUN
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City | MILTON
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State | DE
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Zip | 19968-3086
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Country | US
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Telephone | 609-517-1529
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. KATHERINE KNOWELE ELDER
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Credential | PHD
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Telephone | 609-517-1529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CD 0000020
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC 0000534
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License Number State | DE
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