# B 'N G PSYCHOLOGICAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861073454
- **Authorized official:** DR. THERESA NOWAK PHD (OWNER)
- **Authorized official phone:** (859) 447-6150

## Contact information

- **Practice address:** 233 LARCH LN, LEXINGTON, KY 40511-2006
- **Practice address phone:** (859) 447-6150
- **Practice address fax:** (833) 939-3555
- **Mailing address:** 233 LARCH LN, LEXINGTON, KY 40511-2006
- **Mailing address phone:** (859) 447-6150
- **Mailing address fax:** (833) 939-3555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | Yes |
| 103T00000X | Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 04/15/2021
- **Last updated:** 04/15/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100716770 | — | KY |