Organization
PSYCHOLOGICAL HEALTH SERVICES
Active
Parent organization
PSYCHOLOGICAL HEALTH SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
PSYCHOLOGICAL HEALTH SERVICES
Authorized official
DR. TED S. URBAN ED.D. (OWNER)
(814) 864-9719
Entity
Organization
Contact information
Practice address
956 WEST 38TH STREET, ERIE, PA 16508
(814) 864-9719
(814) 866-1174
Mailing address
956 WEST 38TH STREET, ERIE, PA 16508
(814) 864-9719
(814) 866-1174
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012320370001
—
PA
Enumeration date
02/12/2014
Last updated
02/12/2014
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