Provider Demographics
NPI:1588051262
Name:PSYCHOTHERAPEUTIC SERVICES
Entity type:Organization
Organization Name:PSYCHOTHERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-538-6990
Mailing Address - Street 1:3 CENTERVIEW DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-3725
Mailing Address - Country:US
Mailing Address - Phone:336-834-9664
Mailing Address - Fax:336-834-9698
Practice Address - Street 1:3 CENTERVIEW DR
Practice Address - Street 2:SUITE 150
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3725
Practice Address - Country:US
Practice Address - Phone:336-834-9664
Practice Address - Fax:336-834-9698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management