Psychshield Corporation

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

PSY 4467 Issued in CA

Legal business name

PSYCHSHIELD CORPORATION

Doing business as

Psychshield Behavioral Healthcare

Practice address

4000 Long Beach Blvd Ste 212
Long Beach, CA 90807-2617

Phone

(562) 595-7102

Fax

(562) 595-9112

NPI assigned

Jul 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Wiley D Sutton, PH.D.

Title

Ceo/Psychotherapy Provider

Phone

(562) 595-7102

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Psychshield Behavioral Healthcare Doing business as

Locations

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1437358520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907140250",
            "telephone_number": "562-595-7102",
            "fax_number": "562-595-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 LONG BEACH BLVD STE 212",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072617",
            "telephone_number": "562-595-7102",
            "fax_number": "562-595-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHSHIELD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "WILEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO/PSYCHOTHERAPY PROVIDER",
        "authorized_official_telephone_number": "562-595-7102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": "PSY 4467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "PHD  019  00 N",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychshield Behavioral Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Mental Health Clinic/Center in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.