Provider Demographics
NPI:1902802432
Name:PSYCHOTHERAPY SERVICES ASSOCIATES, LLC
Entity Type:Organization
Organization Name:PSYCHOTHERAPY SERVICES ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-662-6226
Mailing Address - Street 1:PO BOX 1752
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-0752
Mailing Address - Country:US
Mailing Address - Phone:301-662-6226
Mailing Address - Fax:301-682-6040
Practice Address - Street 1:15 N COURT ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5413
Practice Address - Country:US
Practice Address - Phone:301-662-6226
Practice Address - Fax:301-682-6040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD792LMedicare ID - Type UnspecifiedMEDICARE