Provider Demographics
NPI:1487118444
Name:NAHUMCK PSYCHOLOGICAL CORPORATION
Entity type:Organization
Organization Name:NAHUMCK PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:W
Authorized Official - Last Name:NAHUMCK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-720-7890
Mailing Address - Street 1:226 N VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-3334
Mailing Address - Country:US
Mailing Address - Phone:773-720-7890
Mailing Address - Fax:
Practice Address - Street 1:150 W. SIERRA MADRE BLVD
Practice Address - Street 2:
Practice Address - City:SIERRA MADRE
Practice Address - State:CA
Practice Address - Zip Code:91024
Practice Address - Country:US
Practice Address - Phone:626-325-9318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health