Provider Demographics
NPI:1336963685
Name:PSYCHOTHERAPEUTIC SERVICES INC
Entity type:Organization
Organization Name:PSYCHOTHERAPEUTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-810-2468
Mailing Address - Street 1:104 SPRING AVE UNIT 299
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-8512
Mailing Address - Country:US
Mailing Address - Phone:410-778-1933
Mailing Address - Fax:410-778-7988
Practice Address - Street 1:21 SAULSBURY RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3444
Practice Address - Country:US
Practice Address - Phone:302-737-1597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)