Provider Demographics
NPI:1508682923
Name:EASTON PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:EASTON PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HILLARY
Authorized Official - Middle Name:
Authorized Official - Last Name:EASTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LLP
Authorized Official - Phone:248-231-1727
Mailing Address - Street 1:651 BOWERS ST
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-2167
Mailing Address - Country:US
Mailing Address - Phone:248-231-1727
Mailing Address - Fax:
Practice Address - Street 1:3260 COOLIDGE HWY STE 2
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1694
Practice Address - Country:US
Practice Address - Phone:313-497-2725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty