NPIMap

Organization Active NPI

Psychological Services

  • Clinical Psychologist
  • Jackson, TN
National Provider Identifier
1912026188
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
PSYCHOLOGICAL SERVICES
Practice address
156 W University Pkwy
C
Jackson, TN 38305-1617
Phone
(731) 394-0749
Fax
(731) 512-3874
NPI assigned
Mar 28, 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
Mr. Toby AltfeldNPI 1184830143
Title
Executive Director
Phone
(731) 394-0749

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: 193200000X MULTI-SPECIALTY GROUP 103TC0700X TN Primary

Addresses

Primary practice location

156 W University Pkwy
C
Jackson, TN 38305-1617

Mailing address

71 Southwind Dr
Jackson, TN 38305-3963
Phone (731) 394-0749

National Provider Directory

National Provider Directory

Locations

156 W University Pkwy
Ste C
Jackson, TN 38305
Phone (731) 394-0749

Practitioners & affiliated clinicians

Practitioners 5

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": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912026188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 SOUTHWIND DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053963",
            "telephone_number": "731-394-0749",
            "fax_number": "731-512-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 W UNIVERSITY PKWY",
            "address_2": "C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051617",
            "telephone_number": "731-394-0749",
            "fax_number": "731-512-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALTFELD",
        "authorized_official_first_name": "TOBY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "731-394-0749",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

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.