Psychological Associates Professionals Llc in Peoria - Clinical
Psychological Associates Professionals Llc - NPI 1952378192
Psychological Associates Professionals Llc is a Clinical in Peoria, Illinois. Psychological Associates Professionals Llc practices all healthcare services and medical treatments related to Clinical. The NPI Number for Psychological Associates Professionals Llc is 1952378192. The last update date is 2017-08-17.
Psychological Associates Professionals Llc's current location address is 5409 N Knoxville Ave, Peoria, Illinois. You can contact this provider via phone number 3096910420 and fax number 3096910520. The mailing address for Psychological Associates Professionals Llc is 5409 N Knoxville Ave, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Psychological Associates Professionals Llc |
|---|---|
| Address | 5409 N Knoxville Ave, Peoria, Illinois |
| Phone Number | 3096910420 |
| Fax Number | 3096910520 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CLINICAL P |
|---|---|
| Authorized Official Name | Legan R Donald |
| Credentials | ED D |
| Telephone Number | 3096910420 |
NPI Number Detail
| NPI Number | 1952378192 |
|---|---|
| Provider Enumeration Date | 2006-03-07 |
| Last Updated Date | 2017-08-17 |
Provider Mailing Address Detail
| Address | 5409 N Knoxville Ave |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 61614 |
| Phone Number | 3096910420 |
| Fax Number | 3096910520 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 71002085 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7220997 | BCBS | ||
| L015956 | CHAMPUS |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Psychological Associates Professionals Llc by the Centers for Medicare & Medicaid Services?
The Psychological Associates Professionals Llc has been issued the NPI (National Provider Identifier) 1952378192 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Psychological Associates Professionals Llc is located?
The Psychological Associates Professionals Llc is situated at the following address: 5409 N Knoxville Ave, Peoria, IL, 61614.
What is Psychological Associates Professionals Llc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Psychological Associates Professionals Llc's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1952378192 to Psychological Associates Professionals Llc?
The Centers for Medicare & Medicaid Services assigned the 1952378192 to Psychological Associates Professionals Llc on 2006-03-07.
When was the information related to Psychological Associates Professionals Llc most recently updated or refreshed?
The details pertaining to the Psychological Associates Professionals Llc, including its address, specialty, and other relevant information, were last updated or refreshed on 2017-08-17.