Organization
MINDPSI: SCHOOL PSYCHOLOGICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN W FLORELL PH.D. (CEO)
(859) 358-6791
Entity
Organization
Contact information
Practice address
1421 LEXINGTON RD, RICHMOND, KY 40475-1059
(859) 358-6791
(859) 624-2454
Mailing address
1421 LEXINGTON RD, RICHMOND, KY 40475-1059
(859) 358-6791
(859) 624-2454
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
103TS0200X
School Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000676498
ANTHEM PIN
—
Enumeration date
05/30/2008
Last updated
02/13/2012
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