Provider Demographics
NPI: | 1831084649 |
---|---|
Name: | DR. SALUSKY CLINICAL PSYCHOLOGY AND CONSULTING PLLC |
Entity type: | Organization |
Organization Name: | DR. SALUSKY CLINICAL PSYCHOLOGY AND CONSULTING PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | FOUNDER/EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | IDA |
Authorized Official - Middle Name: | R |
Authorized Official - Last Name: | SALUSKY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PHD |
Authorized Official - Phone: | 401-837-2545 |
Mailing Address - Street 1: | 1008 DEWEY AVE # 1 |
Mailing Address - Street 2: | |
Mailing Address - City: | EVANSTON |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60202-1149 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 562-712-3303 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2501 CHATHAM RD STE N |
Practice Address - Street 2: | |
Practice Address - City: | SPRINGFIELD |
Practice Address - State: | IL |
Practice Address - Zip Code: | 62704-4188 |
Practice Address - Country: | US |
Practice Address - Phone: | 401-837-2545 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-06-11 |
Last Update Date: | 2025-06-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty |