Provider Demographics
NPI:1972309771
Name:PRINCIPLE PSYCHOLOGICAL SOLUTIONS, LLC
Entity type:Organization
Organization Name:PRINCIPLE PSYCHOLOGICAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEYONA
Authorized Official - Middle Name:SHANTRICE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:301-613-6520
Mailing Address - Street 1:9658 BALTIMORE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-1346
Mailing Address - Country:US
Mailing Address - Phone:240-283-5595
Mailing Address - Fax:
Practice Address - Street 1:9658 BALTIMORE AVE STE 300
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-1346
Practice Address - Country:US
Practice Address - Phone:240-283-5595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health