Provider Demographics
NPI:1104503473
Name:PSYCHOLOGICAL CONSULTING SERVICES LLC
Entity type:Organization
Organization Name:PSYCHOLOGICAL CONSULTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGY DIRECTOR ANDCEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:GABRIELLE
Authorized Official - Last Name:PATTERSON-HYATT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD,MS, MA
Authorized Official - Phone:347-266-6748
Mailing Address - Street 1:252 BROADWAY
Mailing Address - Street 2:UNIT 611
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-4003
Mailing Address - Country:US
Mailing Address - Phone:253-325-8044
Mailing Address - Fax:
Practice Address - Street 1:252 BROADWAY
Practice Address - Street 2:UNIT 611
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-4003
Practice Address - Country:US
Practice Address - Phone:253-325-8044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty