NPIMap

Organization Active NPI

Psychological Services, Inc.

  • Clinical Psychologist
  • Beckley, WV
National Provider Identifier
1437361466
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
166 Issued in WV
Legal business name
PSYCHOLOGICAL SERVICES, INC.
Practice address
129 Main St Ste 608
Beckley, WV 25801-4670
Phone
(304) 255-0900
Fax
(304) 255-0900
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Charles B. Yeargan, PH.D.NPI 1477631943
Title
President
Phone
(304) 255-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 166 WV Primary

Addresses

Primary practice location

129 Main St Ste 608
Beckley, WV 25801-4670

Mailing address

129 Main St Ste 608
Beckley, WV 25801-4670
Phone (304) 255-0900

Other identifiers 1

IdentifierTypeStateIssuer
0165176000MedicaidWV

National Provider Directory

National Provider Directory

Locations

129 Main St
Ste 608
Beckley, WV 25801
Phone (304) 255-0900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437361466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 MAIN ST STE 608",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014670",
            "telephone_number": "304-255-0900",
            "fax_number": "304-255-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 MAIN ST STE 608",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014670",
            "telephone_number": "304-255-0900",
            "fax_number": "304-255-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YEARGAN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-255-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0165176000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.