Organization
PSYCYNERGY PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE SMITH (EXECUTIVE ASSISTANT)
(708) 566-4950
Entity
Organization
Contact information
Practice address
369 E SIBLEY BLVD, SUITE A, HARVEY, IL 60426-2530
(708) 566-4950
(708) 566-4382
Mailing address
369 E SIBLEY BLVD, SUITE A, HARVEY, IL 60426-2530
(708) 566-4950
(708) 566-4382
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
180004026
IL
101YM0800X
Mental Health Counselor
180004026
IL
101YP2500X
Professional Counselor
180004026
IL
103T00000X
Psychologist
180004026
IL
103TC0700X
Clinical Psychologist
—
—
103TF0000X
Family Psychologist
180004026
IL
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
180004026
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1403
—
IL
Enumeration date
01/05/2016
Last updated
01/05/2016
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