Provider Demographics
NPI:1902444268
Name:PERSONALIZED PSYCHOLOGICAL CONSULTING LLC
Entity Type:Organization
Organization Name:PERSONALIZED PSYCHOLOGICAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULION
Authorized Official - Middle Name:PADRAIC
Authorized Official - Last Name:MARRINAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:914-438-5236
Mailing Address - Street 1:12 ELMCREST CIR
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-1905
Mailing Address - Country:US
Mailing Address - Phone:914-438-5236
Mailing Address - Fax:
Practice Address - Street 1:12 ELMCREST CIR
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-1905
Practice Address - Country:US
Practice Address - Phone:914-438-5236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty