Provider Demographics
NPI:1104422260
Name:PSYCHED PSYCHOLOGICAL SERVICES, INC.
Entity type:Organization
Organization Name:PSYCHED PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF S-CORP./PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOUHY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:805-267-6718
Mailing Address - Street 1:2052 N LARK PL
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-3326
Mailing Address - Country:US
Mailing Address - Phone:805-267-6718
Mailing Address - Fax:805-850-7115
Practice Address - Street 1:3785 VIA NONA MARIE STE 203A
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8637
Practice Address - Country:US
Practice Address - Phone:805-267-6718
Practice Address - Fax:805-850-7115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)