Provider Demographics
NPI:1962772830
Name:PSYCHOLOGICAL ASSOCIATES INC.
Entity type:Organization
Organization Name:PSYCHOLOGICAL ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MUNCY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-235-2000
Mailing Address - Street 1:3120 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-3707
Mailing Address - Country:US
Mailing Address - Phone:614-235-2000
Mailing Address - Fax:614-239-9999
Practice Address - Street 1:3120 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-3707
Practice Address - Country:US
Practice Address - Phone:614-235-2000
Practice Address - Fax:614-239-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5913251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health