Provider Demographics
NPI:1154580421
Name:TOWN AND COUNTRY PSYCHOLOGICAL SERVICES INC
Entity type:Organization
Organization Name:TOWN AND COUNTRY PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:330-332-5203
Mailing Address - Street 1:2539 DEPOT RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-9577
Mailing Address - Country:US
Mailing Address - Phone:330-332-5203
Mailing Address - Fax:
Practice Address - Street 1:2539 DEPOT RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-9577
Practice Address - Country:US
Practice Address - Phone:330-332-5203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2235103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01870667Medicaid
OH0312736Medicaid
OHR03237Medicare UPIN
OH0312736Medicaid