1144259037 NPI number — TOMAS PSYCHOLOGICAL SERVICES, INC

Table of content: (NPI 1144259037)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144259037 NPI number — TOMAS PSYCHOLOGICAL SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOMAS PSYCHOLOGICAL SERVICES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144259037
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
730 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUBBARD
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44425-1126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-699-2682
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
730 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUBBARD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44425-1126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-699-2682
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TOMASOVICH
Authorized Official First Name:
PAULETTE
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
CLINICAL PSYCHOLOGIST
Authorized Official Telephone Number:
724-699-2682

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  6304 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 552120 . This is a "VALUE TIONS/HEALTH AMER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000331274 . This is a "ANTHEM" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: PC001710 . This is a "PROFESSIONAL COUNSELOR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1418538 . This is a "KEYSTONE WESTERN PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 6304 . This is a "LICENSED PSYCHOLOGIST" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 60054 . This is a "AETNA, PA,OH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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