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Organization

PSYCHOTHERAPEUTIC SERVICES, INC

Active
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Organization

PSYCHOTHERAPEUTIC SERVICES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARCIA LYNN CLENDANIEL (BILLING MANAGER)
(410) 810-2465
Entity
Organization

Contact information

Practice address
2260 S. CHURCH ST, SUITE 303, BURLINGTON, NC 27215
(336) 538-6990
(336) 538-6991
Mailing address
2260 S CHURCH ST, SUITE 303, BURLINGTON, NC 27215
(410) 778-9114
(410) 778-7988

Taxonomy

Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
231369010
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3410045
—
NC
05
—
8300588
—
NC
01
—
8300588A
ASSESSTIVE COMMUNITY TX
NC
01
—
8300588V
ALAM CST
NC
01
—
8301181A
PITT ACTT
NC
01
—
8301699A
GUILFORD ACTT
NC
01
—
8301699V
GUILFORD CST
NC
Enumeration date
11/13/2006
Last updated
07/21/2022
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