Provider Demographics
NPI:1891525887
Name:DR. MICHAEL CAIAZZO PSYCHOLOGICAL SERVICES, INC.
Entity type:Organization
Organization Name:DR. MICHAEL CAIAZZO PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:CAIAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:610-718-6919
Mailing Address - Street 1:907 WICK LN
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3337
Mailing Address - Country:US
Mailing Address - Phone:610-718-6919
Mailing Address - Fax:
Practice Address - Street 1:907 WICK LN
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-3337
Practice Address - Country:US
Practice Address - Phone:610-718-6919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty