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General NPI Number Information
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NPI Number | 1699495804
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Entity Type | Organization
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Legal Business Name | JUST PSYCHOLOGICAL SERVICES, PC
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 4850 SW SCHOLLS FERRY RD STE 301
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City | PORTLAND
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State | OR
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Zip | 97225-1696
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Country | US
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Telephone | 503-707-0348
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Fax | 971-266-2868
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Provider Business Mailing Address
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Address Line | 4850 SW SCHOLLS FERRY RD STE 301
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City | PORTLAND
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State | OR
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Zip | 97225-1696
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Country | US
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Telephone | 503-707-0348
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Fax | 971-266-2868
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Authorized Official
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Title or Position | OWNER/CLINICAL PSYCHOLOGIST
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Name | DR. JENNIFER SIMON-THOMAS
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Credential | PH.D.
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Telephone | 503-707-0348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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