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General NPI Number Information
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NPI Number | 1972094845
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Entity Type | Organization
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Legal Business Name | SPECIALIZED PSYCHOLOGY SERVICES, PLLC
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Dates
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Enumeration Date | 05/25/2018
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Last Update Date | 05/25/2018
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Provider Practice Location Address
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Address Line | 501 E PLAZA CIR STE B
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-4917
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Country | US
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Telephone | 480-234-8205
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Fax |
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Provider Business Mailing Address
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Address Line | 15630 W ROMA AVE
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City | GOODYEAR
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State | AZ
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Zip | 85395-6356
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Country | US
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Telephone | 480-234-8205
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. SPENCER T BECK
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Credential | PSYD
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Telephone | 480-234-8205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | PSY-004808
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License Number State | AZ
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