NPIMap

Organization Active NPI

Psychotherapeutic Services Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Dover, DE
National Provider Identifier
1417192584
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
106301 Issued in DE
Legal business name
PSYCHOTHERAPEUTIC SERVICES INC
Practice address
630 W. Division St
Suite F
Dover, DE 19904
Phone
(302) 672-7159
Fax
(302) 672-7178
NPI assigned
Dec 3, 2008
Organization subpart
Yes
Parent organization
PSYCHOTHERAPEUTIC SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Authorized official

Name
Mr. Randall L Cooper
Title
Cfo
Phone
(410) 778-9114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 106301 DE Primary

Addresses

Primary practice location

630 W. Division St
Suite F
Dover, DE 19904

Mailing address

870-2 High Street
Chestertown, MD 21620
Phone (410) 778-9114

Other identifiers 1

IdentifierTypeStateIssuer
0000520561MedicaidDE

National Provider Directory

National Provider Directory
Tax ID family
Psychotherapeutic Services Inc2 organizations share this tax ID, including this one
Part of
Psychotherapeutic SVCS

Other organizations with this tax ID 1

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

Locations

630 W Division St
Ste F
Dover, DE 19904
Phone (302) 672-7159

NPI Registry JSON

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228262400000",
    "number": "1417192584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870-2 HIGH STREET",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "21620",
            "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": "630 W. DIVISION ST",
            "address_2": "SUITE F",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19904",
            "telephone_number": "302-672-7159",
            "fax_number": "302-672-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOTHERAPEUTIC SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PSYCHOTHERAPEUTIC SERVICES INC",
        "enumeration_date": "2008-12-03",
        "last_updated": "2008-12-03",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "410-778-9114",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "DE",
            "license": "106301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000520561",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.