Midsouth Psychological Services, LLC

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

Legal business name

MIDSOUTH PSYCHOLOGICAL SERVICES, LLC

Practice address

996 Wilkinson Trce Ste A8
Bowling Green, KY 42103

Phone

(270) 839-0971

Fax

(270) 393-9835

NPI assigned

Jul 10, 2018

Organization subpart

No

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

Authorized official

Name

Daniel McBride, PHD

Title

Owner

Phone

(270) 839-0971

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536105600000",
    "number": "1780170936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 WILKINSON TRCE STE A8",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421033408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "996 WILKINSON TRCE STE A8",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42103",
            "telephone_number": "270-839-0971",
            "fax_number": "270-393-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDSOUTH PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-09-05",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-839-0971",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Group Psychotherapy Psychologist in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Group Psychotherapy Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.