Provider Demographics
NPI:1548807704
Name:GENERATIONS PSYCHOLOGICAL AND CONSULTATION SERVICES LLC
Entity type:Organization
Organization Name:GENERATIONS PSYCHOLOGICAL AND CONSULTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-328-9528
Mailing Address - Street 1:855 EBNER ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-2361
Mailing Address - Country:US
Mailing Address - Phone:309-531-3504
Mailing Address - Fax:
Practice Address - Street 1:1520 OLD HENDERSON RD STE E
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-3639
Practice Address - Country:US
Practice Address - Phone:309-531-3504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health