Organization Name: | CONNECTED PSYCHOLOGICAL SERVICES LLC |
NPI Number: | 1013396324 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CELESTE SHOWERS SULC (CEO) |
Mailing Address: | 313 Park Ave Suite 203 Falls Church |
State: | VA US |
Postal Code: | 220463327 |
Phone Number: | 5712763113 |
Fax Number: | |
NPI Enumeration Date: | 05/20/2015 |
NPI Last Update Date: | 05/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | 0810003521 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |