NPIMap

Organization Active NPI

Psychotherapeutic Services, Inc

  • Psychiatry Physician
  • Greenville, NC
National Provider Identifier
1164616264
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PSYCHOTHERAPEUTIC SERVICES, INC
Practice address
1990 Allen Rd
Suite F
Greenville, NC 27834-0058
Phone
(252) 756-1005
Fax
(252) 756-1085
NPI assigned
Aug 31, 2007
Organization subpart
Yes
Parent organization
PSYCHOTHERAPEUTIC SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Randall Cooper, CPA
Title
Cfo
Phone
(410) 778-9114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1990 Allen Rd
Suite F
Greenville, NC 27834-0058

Mailing address

870 High St
Suite 2
Chestertown, MD 21620-3909
Phone (410) 778-9114

Other identifiers 1

IdentifierTypeStateIssuer
8301181MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Psychotherapeutic SVCS44 organizations share this tax ID, including this one
Part of
Psychotherapeutic SVCS

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

1990 Allen Rd
Ste F
Greenville, NC 27834
Phone (252) 321-2225

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1164616264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 HIGH ST",
            "address_2": "SUITE 2",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216203909",
            "telephone_number": "410-778-9114",
            "fax_number": "410-778-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 ALLEN RD",
            "address_2": "SUITE F",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278340058",
            "telephone_number": "252-756-1005",
            "fax_number": "252-756-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOTHERAPEUTIC SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PSYCHOTHERAPEUTIC SERVICES, INC",
        "enumeration_date": "2007-08-31",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "410-778-9114",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301181",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.