Provider Demographics
NPI:1902073653
Name:PSYCHOLOGICAL HEALTH CONSULTANTS
Entity Type:Organization
Organization Name:PSYCHOLOGICAL HEALTH CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:616-842-1277
Mailing Address - Street 1:1703 S DESPELDER ST
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-2649
Mailing Address - Country:US
Mailing Address - Phone:616-842-1277
Mailing Address - Fax:616-842-4190
Practice Address - Street 1:1703 S DESPELDER ST
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2649
Practice Address - Country:US
Practice Address - Phone:616-842-1277
Practice Address - Fax:616-842-4190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)