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General NPI Number Information
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NPI Number | 1821441106
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL MANAGEMENT SERVICES
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Dates
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Enumeration Date | 07/21/2016
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Last Update Date | 07/21/2016
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Provider Practice Location Address
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Address Line | 2424 INDIA HOOK SUITE 100
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City | ROCK HILL
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State | SC
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Zip | 29732
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Country | US
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Telephone | 704-231-6927
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Fax |
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Provider Business Mailing Address
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Address Line | 2424 INDIA HOOK SUITE 100
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City | ROCK HILL
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State | SC
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Zip | 29732
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Country | US
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Telephone | 704-231-6927
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES PINKNEY
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Credential | PH.D.
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Telephone | 704-231-6927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional 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 | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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